Five things about Pap tests that might surprise you

Pap tests (or Pap smears) are well accepted tests that check for changes in the cells of the cervix (the lowest part of the uterus or womb) and screen for precancerous and cancerous lesions.pap1

Pap tests are able to detect problems early and treatment may prevent cancer. Data shows that Pap screening has lowered the cervical cancer rate in the United States by more than 50% over the last 30 years.

This test is such a familiar part of our healthcare routine that many women might be surprised to learn five important things about the Pap test:

You don’t need to have a Pap test every year.

Some of my patients are surprised by the new guidelines stating that annual screening is not recommended across the board for all women.

In October 2012, the American College of Obstetricians and Gynecologists, joined the American Cancer Society and the American Society for Colposcopy and Cervical Pathology with the following recommendations

  • Women ages 21-29 should have a Pap test every 3 years.
  • Women ages 30-65 should have a Pap test every 3 years.  Women over 30 have the option of having the test done along with HPV (Human Papilloma Virus, the virus that causes a majority of cervical cancers) testing. With normal results for both tests, women can wait five years in between tests.

More frequent screenings may be appropriate for women with a history of cervical cancer, women who are HIV-positive and women whose immune system is not working properly. Ask your doctor about your screening frequency, and do not skip this important test!

Don’t get a Pap test during your period.

For the most accurate results, you should not have a Pap test during your period. It is also preferable that you don’t douche, use tampons or have sex for 48 hours before your test, since all of those activities can hide abnormal cells.  In addition, women who have recently completed chemotherapy should wait 6 months to a year to have their Pap tests.

It doesn’t matter if you’ve gone through menopause.

Women who have gone through menopause should still get regular Pap tests according to the guidelines. Women ages 65 and older can talk to their doctor about stopping testing after at least 3 normal Pap tests and no abnormal results in the last 10 years.

Pap tests are still important if you’ve had the HPV vaccine.

Women who have received the HPV vaccination should follow the standard cervical cancer screening guidelines. Approximately 70% of the population is infected with the human papillomavirus which frequently can be quiet. Someone can be exposed at age 21 and not have symptoms until years later.

Not all positive Pap results mean you have cancer.

According to the American College of Obstetricians and Gynecologists, the majority of cervical abnormalities that occur related to HPV infection in young women usually spontaneously resolve and don’t require treatment. No screening is perfect, so there are false positive results from time to time.  That is why follow up is important – false positives usually trigger further testing which will reveal if there is cause for concern or not.

If you haven’t been tested according to the above guidelines, it’s important that you do so.  Being rarely or never screened is the major contributing factor to most cervical cancer death.


Learn more about Pap Tests


Elisabeth Quint, MD, is director of the hysterectomy alternative (HALT) clinic for women with fibroids and abnormal uterine bleeding and co-director of the pediatric and adolescent gynecology clinic at University of Michigan Health System.



The University of Michigan’s Women’s Von Voigtlander Women’s Hospital is a leader women’s health care.  Consistently ranked among the America’s top gynecology programs by U.S. News & World Report, U-M is committed to unsurpassed patient care.