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Pap smear and HPV Screening

doctor holds a disposable speculum in his hand_edited.jpg

What is a Pap smear or test? 

Pap tests or Pap smears look for cancers and precancers in the cervix. Precancers are cell changes that can be caused by the human papillomavirus (HPV). If not treated, these abnormal cells could lead to cervical cancer. Most women 21 to 65 years old need to get Pap tests or a Pap test and HPV test together. Not all women need to be tested every year.

A Pap test is a test your provider does to check your cervix for any cells that are not normal. The cervix is the lower part of the uterus (womb), which opens into the vagina. Abnormal cervical cells, if not found and treated, can lead to cervical cancer.

During a Pap test your healthcare provider inserts a speculum, a tool that helps your provider to see your cervix, into your vagina and uses a special broom or soft brush to collect cells from the outside of your cervix. The cells are sent to a laboratory for testing.

What is an HPV test?

An HPV test looks for DNA from HPV in cells from your cervix. The cervix is the lower part of the uterus or womb, which opens into the vagina. HPV is a sexually transmitted infection (STI) that goes away on its own in most people. If it does not go away, HPV can cause abnormal cervical cells that can lead to cervical cancer. Certain types of HPV are more likely to cause cervical cancer. The HPV test can tell your provider if you have HPV and which type it is. During an HPV test, your provider puts a speculum, a tool that helps to see your cervix into your vagina and uses a soft brush to collect cells from the outside of your cervix. The cells are tested in a laboratory.

Pap tests and HPV tests can be done at the same time, called co-testing.

Why do I need a Pap and HPV test?

A Pap test can save your life. It can find cervical cancer cells early. The chance of successful treatment of cervical cancer is very high if the disease is caught early. Pap tests can also find abnormal cervical cells before they become cancer or precancers. Removing these precancers prevents cervical cancer over 95% of the time. An HPV test can give your provider more information about the cells from your cervix. For example, if the Pap test shows abnormal cervical cells, the HPV test can show whether you have a type of HPV that causes cervical cancer.

Who should get the Pap and HPV Tests. 

Most women 21 to 65 years old should get Pap tests as part of routine gynecological annual exam. Even if you are not currently sexually active, got the HPV vaccine, or have gone through menopause, you still need regular Pap tests.

The recommendation according to The American College of Obstetricians and Gynecologists:

  • Women 21–29 get a Pap test every 3 years

  • Women 30–65 get:

    • A Pap test every 3 years, or

    • An HPV test every 5 years, or 

    • A Pap and HPV test together ,called co-testing, every 5 years

  • Women older than 65 need a Pap test if they have never been tested, or if they have not been tested after age 60.

  • HPV tests are recommended for women 30 and older. Although HPV is common in women younger than 30, it usually goes away on its own in these women. Pap tests combined with HPV tests, or HPV tests alone, are most useful for women 30 and older.

***Some women may need Pap or HPV testing more often.

Is the Pap and HPV Test Painful? 

Some women find Pap and HPV tests uncomfortable, but the tests should not be painful. You will feel pressure as your provider puts the speculum into your vagina. If you have never had sexual intercourse or if you have had pain when something is put into your vagina, you can ask your doctor or nurse to use a smaller speculum. You can also help lessen or prevent pain by urinating before the test to empty your bladder or by taking an over-the-counter pain reliever, such as aspirin, acetaminophen, or ibuprofen, about an hour before your Pap or HPV test.

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