Patient Education Frequently Asked Questions (FAQs)

  1. What is the Pap test?
  2. Who needs to get a Pap test?
  3. What is HPV?
  4. Should I get an HPV test?
  5. Do I have to get a Pap test every year?
  6. How do I prepare for a Pap test?
  7. When is the best time to have a Pap test done?
  8. Who should get vaccinated for HPV?
  9. If I have been vaccinated for HPV, do I still need to get a Pap test?
  10. What if my Pap test is normal?
  11. What if my Pap test is abnormal?
  12. I have heard that a Pap test can be wrong? Is this true?
  13. When can I stop getting Pap tests?

The PAP test: Screening for Cervical Cancer

What is the Pap test?

  • The Pap test is a screening test to look for abnormal cells on the uterine cervix (the opening of the uterus).
  • Cells are scraped from the cervix and examined under the microscope for abnormalities.
  • Abnormal cells may or may not indicate a precancerous change.

Who needs to get a Pap test?

  • Women aged 21-65.
  • Women who are older than 65 years old with a history of a precancerous lesion of the cervix or cervical cancer.
  • Women who had a hysterectomy for a cervical high grade lesion.

What is HPV?

  • Human papillomavirus (HPV) is a virus that infects epithelial (skin) cells.
  • There are more than 150 types of HPV. There are more than 40 types that infect the genital areas of males and females. More than 14 types have been linked to cervical cancer.
  • HPV is transmitted by vaginal, anal, or oral sexual contact.
  • Women over 30 years old should be tested for HPV if possible when they have a Pap test.  The combination of Pap test and HPV test results can allow less frequent screening in some women over 30.
  • Women 21 years or older should be tested for HPV if their Pap test shows atypical squamous cells of undetermined significance (ASC-US).

Should I get an HPV test?

  • HPV infections are extremely common, particularly in women in their 20’s.
  • Many women will have positive HPV tests but most of these infections will go away by themselves; therefore it doesn’t make sense to test everyone.
  • HPV tests are recommended in two circumstances.
    • Under the age of 30, HPV tests are recommended for women with mild Pap cytology changes that are not definitive (Atypical Squamous cells of Undetermined Significance or ASC-US). If you had a liquid-based Pap test, the laboratory will automatically perform this test if requested by your doctor.
    • Over age 30, an HPV test is recommended in addition to the Pap test for everyone in order to plan how often future Pap tests should be performed.
  • If you cannot get an HPV test, your doctor can still perform routine Pap tests with appropriate follow-up.

Do I have to get a Pap test every year?

  • The frequency of the Pap test depends on your recent Pap test result.
  • If your Pap test is normal and/or you have a negative HPV test, then you do not have to have a Pap test every year.
    • For women 21-29 years old: A Pap test every three years is sufficient.
    • For women 30-65 years old: A Pap test should be performed every five years with an HPV test at the same time or every three years without an HPV test.
  • If your Pap test is abnormal, your doctor will advise you on the next step and future Pap testing.

How do I prepare for a Pap test?

  • Do not use lubricant gels, birth control foams or jellies, or medicated vaginal creams for at least two days before having a Pap test.
  • Do not douche for at least two days before having a Pap test.
  • Avoid sex for at least two days before having a Pap test.
  • Write down the date of your last period and any unusual symptoms such as vaginal discharge for discussion with your doctor.

When is the best time to have a Pap test done?

  • The best time to have a Pap test done is around the middle of your cycle; approximately 14 day after your period starts.
  • Do not have a Pap test during your period. The blood will interfere with the test.
  • If you are experiencing abnormal vaginal bleeding, please see your doctor as soon as possible.

Who should get vaccinated for HPV?

  • Girls and women aged 11-26 years should be vaccinated for HPV.
  • It is best to have the vaccine before you start sexual activity. This is because the vaccine is best at preventing infection before exposure by the most important HPV types.
  • If you already have an HPV infection, the vaccine will not cure it. However, vaccination is still preferred.
  • You should not get the vaccine if you are allergic to any of the components of the vaccine, or if you are pregnant.

If I have been vaccinated for HPV, do I still need to get a Pap test?

  • Yes. The vaccines are not effective against all HPV types, just the ones most commonly associated with cancer.
  • Even if you have been vaccinated for HPV you should still have Pap tests according to the same schedule as someone who has not been vaccinated.

What if my Pap test is normal?

  • If your Pap test is normal and you have not had an HPV test, you should have another Pap test in 3 years.
  • If your Pap test is normal and you have also had a negative HPV test at the same time, your next Pap test can be performed in 5 years.
  • If your Pap test is normal but you had a positive HPV test at the same time, you should talk to your doctor about what to do next.
  • Even though you may not be required to have an annual Pap test, it is still important to see your doctor on an annual basis for continued clinical care.

What if my Pap test is abnormal?

  • If your Pap test is abnormal (ASC-US) your doctor may ask you for a HPV test. This information can help to determine the next step.
  • The treatment for an abnormal Pap test will be different depending on the severity of the abnormality. Your doctor may want to do a procedure called a colposcopy, which allows them to take a closer look at the cervix to identify the abnormal area. Your doctor may take a biopsy sample of the abnormal area in order to make a more definitive diagnosis.

I have heard that a Pap test can be wrong? Is this true?

  • The Pap test is not 100% accurate. It is possible that the Pap test will miss abnormal cells even when they are there.
  • Repeating the Pap test at recommended intervals is the best way to ensure that an abnormality is detected.

When can I stop getting Pap tests?

  • As long as you do not have a history of cervical cancer or certain precancerous conditions, you can stop getting Pap tests after you turn 65 or after you have a total hysterectomy (in which the cervix is removed).
  • You do not need to have a Pap test if you have had a hysterectomy (removal of the cervix) regardless of age.  However, it is still important that you follow your doctor’s instructions for clinical evaluations.