Preparing for Your First Pap Smear

This screen­ing allows your physi­cian to observe cel­lu­lar changes and abnor­mal­i­ties on your cervix and can also iden­ti­fy your like­li­hood of devel­op­ing cer­vi­cal can­cer. The ear­ly detec­tion of abnor­mal cells plays a vital role in slow­ing or stop­ping the devel­op­ment of can­cer growth. Between 74 and 83 per­cent of cer­vi­cal can­cer cas­es are direct­ly relat­ed to a viral infec­tion known as the Human Papil­lo­ma Virus (HPV). HPV typ­i­cal­ly has no symp­toms, mak­ing Pap smears an essen­tial step in catch­ing abnor­mal­i­ties early.

What should I expect?

Dur­ing your Pap smear, your physi­cian will insert a tool called a specu­lum into your vagi­na to exam­ine your cervix. Using a brush or spat­u­la, a sam­ple of cer­vi­cal cells will be col­lect­ed and sent for testing.

If pos­si­ble, it is best to avoid sched­ul­ing a Pap smear dur­ing your peri­od as it could affect test results. If you are unable to sched­ule your screen­ing around your peri­od, you should still attend your appoint­ment and receive your Pap smear.

When should I get a Pap smear?

Many fac­tors play a role in Pap smear require­ments, including:

• Age
• Med­ical history
• HIV sta­tus
• Whether you have a weak­ened immune sys­tem or were exposed to diethyl­stilbe­strol (DES) before birth

Although your indi­vid­ual health and pap his­to­ry will be tak­en into con­sid­er­a­tion when deter­min­ing how often you should have a screen­ing, the gen­er­al guide­lines accord­ing to The Amer­i­can Col­lege of Obste­tri­cians and Gyne­col­o­gists are:

Women ages 20 years and younger: No screen­ing required
Women ages 21 – 29 years: Pap test every 3 years
Women ages 30 – 64 years: Pap test every 3 years, HPV test every 5 years or co-test­ing (Pap and HPV tests) every 3 – 5 years*
Women ages 65 years and old­er: No screen­ing required if ade­quate­ly screened pri­or to age 65
Women who have had a hys­terec­to­my and cervix removal: Screen­ing may be required
*At the dis­cre­tion of your physician 

Test­ing fre­quen­cy will vary based on past abnor­mal test results. Most women over the age of 65 will no longer need a Pap smear, how­ev­er, this depends on indi­vid­ual risk fac­tors. Pap smears may still be nec­es­sary if you’ve had a hys­terec­to­my or a total removal of the uterus and cervix.

When can I expect my results?

You can expect your Pap smear results one to three weeks after your screen­ing. Many women have abnor­mal Pap smear results and often­times, abnor­mal cells return to nor­mal on their own. A repeat screen­ing or fur­ther test­ing may be required. In some cas­es, a biop­sy or col­poscopy may be done to mea­sure the sever­i­ty of your cer­vi­cal changes.

Types of abnormalities:

There are many com­mon cell abnor­mal­i­ties that are present in pos­i­tive test results, including:

• Atyp­i­cal Squa­mous Cells of Unde­ter­mined Sig­nif­i­cance (ASCUS)

These cells are mild­ly abnor­mal but do not meet the cri­te­ria for pre­can­cer­ous cells. In the case that human papil­lo­mavirus (HPV) is present, your physi­cian may rec­om­mend fur­ther testing.

• Squa­mous Intraep­ithe­lial Lesion

These lesions can be indi­ca­tors of pre­can­cer­ous cel­lu­lar changes and fre­quent­ly require addi­tion­al test­ing. A col­poscopy is usu­al­ly rec­om­mend­ed, depend­ing on age and pap results, with or with­out biop­sy, to get a mag­ni­fied view of the cervix, vul­va and vagi­na. Lesions can be low-grade with low can­cer risk or high grade with high can­cer­ous risk. They could also be atyp­i­cal glan­du­lar cells, which are abnor­mal cells in the endo­cervix requir­ing extra test­ing or squa­mous cell can­cer, also known as ade­no­car­ci­no­ma. Depend­ing on the cell type, such lesions may sig­nal the like­li­hood of cancer.

Cer­vi­cal can­cer screen­ings play a vital role in the ear­ly detec­tion of abnor­mal cells. Dis­cov­er more tips on women’s health, or sched­ule an appoint­ment with your obste­tri­cian or gynecologist.