What is a Pap test?

A Pap test (sometimes called a Pap smear) is a screening test during which a sample of cells is taken from a woman’s cervix and vagina. The test detects changes in the cells of the cervix prior to the development of clinical problems.

The Pap test is your best protection against cervical cancer. A Pap test might help your healthcare provider detect a problem before you are aware that something is wrong. Early detection is critical to a successful outcome.

When should a Pap test be performed?

Several national guidelines recommend:

Low risk patients:
  • Cervical cancer screening should begin at age 21 years regardless of sexual history.
  • For women aged 21 to 29 years, cervical cytology screening is recommended every 3 years.
  • For women 30 years and older, who have had 3 consecutive negative (normal) PAP tests, the recommended screening interval may be continued at every 3 years. The recommended screening interval is every 5 years if HPV (human papillomavirus) testing is performed along with the routine Pap test. Women are candidates for this less frequent Pap testing schedule if they are HPV negative and have no history of CIN 2 or CIN 3 (Cervical Intraepithelial Neoplasia, which are potentially precancerous cells).
  • Women who have HIV, another immunocompromised state (such as those who have had an organ transplant) or DES (diethylstilbestrol) exposure while in the womb should continue with yearly pap tests.
  • Routine Pap testing should be discontinued in women who have had a total hysterectomy for benign conditions, assuming they have no history of high-grade CIN.
  • Cervical cancer screening can be discontinued at age 65 in women who have 3 or more consecutive negative cytology test results and no abnormal test results in the past 10 years.

What is the HPV test?

The HPV (human papillomavirus) test detects the presence of a virus that can cause abnormal cervical cells or cervical cancer. HPV infection has been shown to be the primary cause of almost all cancerous and precancerous conditions of the cervix. A sample for HPV testing is collected with the Pap smear sample in women over the age of 30. Women younger than age 30 should not have HPV testing done routinely, as many HPV infections in this age group are temporary, and can lead to unnecessary tests and procedures. However, in women aged 21 to 29, HPV testing is often performed on the Pap smear specimen after an abnormality has been detected, without requiring a second visit (to help understand how to address the abnormal Pap result).

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