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Pap Smear
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Pap Smear

A Pap smear is a screening test used to detect abnormal cervical cells before they develop into cancer, allowing for early intervention and prevention.

What is a Pap Smear?

A Pap smear is a test to screen for cervical cancer. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer develops slowly; before cancer appears, cells go through changes called dysplasia. If not destroyed or removed, these abnormal cells may become cancer.

During a Pap smear, your health care provider collects cells from your cervix to be checked under a microscope for cancer or precancerous changes. Finding and treating these cells early can help prevent cervical cancer.

What is it used for?

A Pap smear looks for abnormal changes in cervical cells. It is often performed alongside an HPV (human papillomavirus) test. HPV is a group of viruses that can spread through sexual contact; long-lasting infections with high-risk types of HPV cause almost all cervical cancers.

How often do I need a Pap smear?

Recommendations depend on your age and health history:

  • Ages 21–29: First Pap smear at age 21. If results are normal, you may wait three years for the next test. At age 25, you should begin screening with an HPV test every five years.
  • Ages 30–65: You may have a Pap smear every three years, or if you have an HPV test (or co-testing with both), you may wait five years if results are normal.
  • Over age 65: Talk to your provider; if you have had regular screenings with normal results, you may no longer need them.

You may need more frequent screening if you have a history of abnormal results, a diagnosis of cervical cancer, HIV, a weakened immune system, or were exposed to the drug DES before birth.

What happens during a Pap smear?

During the procedure:

  • You will lie on an exam table with your knees bent and heels in stirrups.
  • Your provider will insert a speculum into your vagina to widen it so the cervix can be seen.
  • A small, soft brush or swab is used to collect cells from the cervix.
  • The sample is sent to a lab for examination.

Preparation and Risks

To ensure accurate results, avoid the following for two days before your test:

  • Using tampons
  • Using birth control foam, jelly, or cream
  • Using other vaginal creams or medicines
  • Douching
  • Having vaginal sex

Do not schedule the test during your period; the best time is about five days after it ends. There are no known risks to the test, though you may feel mild discomfort or experience light bleeding afterward.

What do the results mean?

  • Normal or "negative": No abnormal changes were found.
  • Unsatisfactory: The sample may have had too few cells or was obscured by mucus; you may need to repeat the test.
  • Unclear: Cells look abnormal, but it is unclear if it is due to HPV, pregnancy, menopause, or infection.
  • Abnormal or "positive": Abnormal changes were found. This does not usually mean you have cancer, but your provider may recommend follow-up tests, such as a colposcopy, to investigate further.

Frequently Asked Questions

If you are 30–65 and have had a negative HPV test with a normal Pap, you can wait five years. However, if you have had only an HPV test without a Pap, you still need a Pap to confirm no cellular abnormalities. Always follow your provider’s recommendation.===
If you are 21–29 and your last Pap was normal, you can wait three years for the next test. If you are 30–65 and your last Pap and HPV test were normal, you can wait five years with co‑testing or three years with a Pap alone. After 65, discuss with your provider whether to stop or continue based on your history.
The provider will insert a speculum, gently scrape cells from the cervix with a brush or spatula, and then remove the speculum. To ease discomfort, try breathing deeply, relaxing your pelvic muscles, and informing the provider if you feel pain. A local anesthetic spray is rarely used but can be requested.
n abnormal result usually leads to a colposcopy, where a magnified view of the cervix is taken and a biopsy may be performed. The severity depends on the grade of dysplasia; low‑grade changes often resolve, while high‑grade changes may require treatment such as loop electrosurgical excision or cryotherapy. Follow your provider’s plan and attend all follow‑up appointments.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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