Perhaps you're in your early 20s and have just heard about pap smears, or you've been getting them for years but aren't exactly sure what they're for.
The pap smear or pap test, named after Dr. Papanicolou, is a potentially life-saving screening test. So it's important to know what this test can and cannot do, who it's for, how to prepare for it, and what to expect.
What is it?
The pap smear tests for cervical cancer or abnormal cells that have the potential to become cancer.
It’s done by collecting cells from your cervix using a small brush or spatula and testing them under a microscope. The cervix is located at the entrance of the uterus, at the top of the vaginal canal .
Sometimes, an HPV test will also be done using the same method. HPV stands for human papillomavirus. It is a sexually transmitted virus that can cause genital warts and may increase the chance of developing cervical cancer.
A pap smear does NOT test for:
- STDs such as herpes, gonorrhea or chlamydia
- ovarian cancer
- ovarian cysts 
Who is it for?
Pap smears are important for anyone with a cervix between the age of 21 and 65. It's recommended to test for cervical cancer once every three years between the ages of 21 and 30.
Between the ages of 30 and 65, it's recommended to test every 3 years, or every 5 years if both a pap smear and HPV test are done. After age 65 or after a total hysterectomy, people can generally stop routine testing if all previous tests were negative and if there are no additional risk factors .
It's important to get tested even if you have never been sexually active, as it's still possible to develop cervical cancer. If you have additional risk factors, such as HIV infection, a weakened immune system, a history of smoking, exposure to diethylstilbestrol (DES) before birth, or a previous pap smear that showed precancerous cells, your doctor might recommend more frequent testing .
How to prepare for it?
The best time to get a pap smear is between the 14-28th day of your menstrual cycle, or at least 5 days after your period ended. While it's possible to do a pap smear while on your period, the results may be less accurate, so consider rescheduling for after your period is over.
Before making an appointment with a gynaecologist, it might be helpful to track your period so that you can more accurately predict when it will come. There are multiple period-tracking apps or hormone-testing kits, such as the inne minilab, that you can use to help you.
It's also recommended that you avoid vaginal sex for two days before the exam. This is because sperm can obscure test results by mimicking atypical cells . Additionally, avoid using tampons, vaginal creams, birth control foams or jellies, lubricants, and douches at least two days before the test .
What to expect?
A pap smear is usually done as part of a pelvic exam. During a pelvic exam, your doctor will insert a speculum into your vagina, or a device that helps to open the canal and see more clearly to check if everything is healthy.
With the speculum still inserted, your gynaecologist will then take a small brush or spatula, put it through the speculum, and try to collect cells from your cervix by gently scraping it. These cells are quickly smeared on a glass slide and “fixed” onto it. The pap smear is a very quick test that doesn't usually take more than a couple of minutes.
A lab technician will observe the slide under the microscope to look for cancerous or precancerous cells . It can take up to three weeks for pap smear results.
During the test, you might feel some slight discomfort and pressure, but not pain. There might be some bleeding afterwards. Notify your healthcare provider if bleeding lasts longer than 24 hours .
What happens next?
There are three possible results after a pap smear test:
- Normal - No abnormal cells were found
- Unclear - The lab technician couldn't determine the results. In this case, it might be necessary to repeat the exam.
- Abnormal - The cells don't look as they should. Finding unusual cells doesn't necessarily mean that you have cancer, but follow-up tests will be necessary. The pap smear is a screening test, and can't be used to diagnose .
The pap smear is an easy, reliable, and lifesaving screening tool. If precancerous cells are found and treated, there's a more than 95% chance that they won't develop into cervical cancer . So it's important to take responsibility for the health of your cervix by getting tested at the recommended intervals, despite the minor inconvenience every couple of years.