A Pap smear is a common, painless method to screen for cervical cancer. For people with normal results, it's recommended, depending on your age, that you have a pap every three to five years.

Paps are not needed for women who are younger than 21. Women who are between 21 and 30 need a pap only every three years, as long as results continue to come back "normal." Women from 30 to 65 can get a pap every three years or a pap with co-testing (meaning human papilloma virus, HPV, is included on the pap) every five years.

After age 65, a Pap smear may be done at the discretion of your medical provider. If you have had a hysterectomy — where your uterus and cervix were removed — Paps are not needed, unless the hysterectomy was done for cervical cancer.

What's a Pap smear?

A Pap, short for Papanicolaou test, is very valuable for the early detection of cancer of the cervix. The cervix is the opening connecting the uterus and vagina. A doctor takes a sample of the cells from the cervix and puts them in a vial containing liquid. The cells are stained and carefully examined under a microscope.

While it's recommended most people have a Pap every three to five years, you may need more frequent Pap smears if you:

  • Are HIV-positive
  • Have a weakened immune system

What to expect during a Pap smear

Always check with your healthcare provider before preparing for a Pap smear. Typical preparation includes:

  1. Schedule your visit for approximately two weeks after the first day of the last menstrual period.
  2. Stop using vaginal medications 72 hours before the exam.
  3. Abstain from sexual relations 24 hours before the exam.

During the procedure, you’ll lie on your back on an examination table with your feet resting in supports called stirrups. Your provider will slowly insert a device called a speculum into your vagina. This device keeps the vaginal walls open and allows your provider to see the cervix.

Your doctor or nurse practitioner will then use a tool called a spatula and also a brush to collect a small sample of cells from your cervix.

There are two types of Pap smears that can be ordered by your health care provider. One looks only at the cells in your cervix.

The other, known as contesting, looks at the cells and also looks for any DNA particles of HPV. Pap smears with co-testing for HPV is more accurate than Pap smears alone. HPV is a cause of cervical cancer and co-testing is a valuable addition to the Pap smears.

If your provider orders a Pap smear without HPV testing, this will need to be repeated in three years. If co-testing is ordered, your next Pap smears will be in five years if the results of either the Pap smears alone or the one with co-testing are normal.

If you’re between the ages of 21 and 30, you may not need a Pap smear with co-testing. You can discuss this with your provider.

A "negative" Pap smear is good — it means the patient is at lower risk for cervical cancer. A "positive" or "abnormal" result indicates that further testing is needed. It doesn’t mean that you have cervical cancer.

The follow up options depend on the results and will be discussed with you by your provider.

Depending on the result, it may be recommended that you have a colposcopy, which is an office procedure where a doctor takes a closer look at your cervix using a magnifying lens. The doctor may want to take a biopsy (a specimen of tissue) for microscopic examination by the lab to determine if precancerous or cancerous cells are present. Follow up options would be determined by the result.