The Pap Test
What is a Pap test?
A Pap test is a test that may find changes on your cervix. During a Pap test, cells are taken from your cervix, placed on a slide and sent to a lab for assessment. In most cases, the cells are normal.
If you have an abnormal Pap test, you will be asked to come back for a repeat Pap test, or you may be referred for a colposcopy, an examination of the cervix and vagina using a low-powered magnifying instrument.
Be sure to keep all appointments after an abnormal Pap test.
What is the cervix and where is it located?
The uterus (womb) is made up of two parts. The upper part is the place where a baby grows. The cervix is the lower part of the uterus, joining the womb to the vagina. Abnormal cells (cervical dysplasia) may develop at this opening to the womb.
What causes abnormal changes?
Human Papillomavirus, or HPV, is a very common sexually transmitted virus that can cause abnormal changes on your cervix. Eight percent of women will have an abnormal Pap test each year in Manitoba.
Why should I have Pap tests?
Sometimes abnormal changes caused by HPV can become cancerous. A Pap test can find these abnormal changes before they turn into cancer. Regular Pap tests with follow-up for abnormal changes can prevent most cancer of the cervix.
What should I do before the test?
- Schedule your Pap test after your period (menstruation) has stopped completely,
- Schedule your Pap test two weeks after treatment for any cervical or vaginal infection,
- Do not use tampons, douches, creams and/or foams for 48 hours before your Pap test, and
- Try not to have sexual intercourse for 24 hours before the test.
- Let your health care provider know if you have had any abnormal vaginal bleeding, spotting or pain.
- If you are anxious during your test, try some relaxation exercises, like deep breathing. Consciously try to relax your thigh muscles.
Am I at risk for HPV?
If you have ever had sex or experienced intimate touching, you are at risk for HPV. If you have only had one sexual partner and/or you have only had sex once, you are still at risk for HPV and cervical cancer.
HPV is very common. Three out of four people will have at least one HPV infection in their lifetime. You can get HPV easily from oral, genital or rectal sex or intimate touching. Most infections will disappear on their own. When they do not disappear, these changes can be found with a Pap test and treated with follow-up procedures.
Who should be screened?
All women who have ever been sexually active (sexual intercourse and intimate touching), regardless of sexual orientation, should have regular Pap tests.
Do women who have never had sexual intercourse need Pap tests?
HPV can be spread though sexual intercourse as well as intimate genital contact. If a woman has experienced intimate genital contact with one or more partners then she should start having Pap tests three years after she began sexual activity.
How often should I have a Pap test?
You should start having Pap tests three years after you become sexually active. Most women need a Pap test at least every two years. Talk to your doctor or nurse about what is best for you.
If my Pap test is abnormal, does it mean I have cancer?
No, it does not. In most cases, cancer is not the reason for an abnormal Pap test. Most of the time, abnormal changes will disappear on their own without any treatment. You may need a repeat Pap test, or in some cases, you may need colposcopy. Most women who have abnormal Pap test results and who have follow-up test and/or treatment will never get cancer of the cervix.
When can I stop having Pap tests?
If you are 70 years of age or older and have had three or more normal Pap tests in the previous 10 years with no change in sexual partner, you may be able to stop having Pap tests. Talk to your doctor or nurse about what is best for you.
If I am past menopause, do I still need a Pap test?
Yes. A post-menopausal woman should continue to be screened regularly. A woman may be able to stop having Pap tests at age 70 years of age or older if she has had three or more normal Pap tests in the previous 10 years with no change in sexual partner.
I've had a hysterectomy. Do I still need Pap tests?
Maybe. Talk to your doctor about what is right for you.
I am a lesbian. Do I need Pap tests?
Lesbian women, as well as women who may not identify as lesbian but who have sex with women (WSW), have a lower incidence of HPV and invasive cervical cancer. Nevertheless, this population is still at risk.
If you have ever been sexually active (including oral sex, sex with toys and sex with fingers) you need a Pap test at least every two years.
I am transgender. Do I need Pap tests?
All Male-to-Female (MTFs) and Female-to-Male (FTMs) who have ever been sexually active (including oral sex, sex with toys and sex with fingers) should have a Pap test at least every two years.
A careful health history should occur with your doctor or nurse, in order to determine the your specific screening needs.
What if I have a disability?
If you have a disability that may impact the way the Pap test is performed, talk to your doctor or nurse about your specific needs. Click on "Where can I go for a Pap test"to find out about accessibility options and locations available.
What happens at a Pap test?
Before going into the examination room it's a good idea to empty your bladder. The doctor or nurse will introduce him/herself, ask you a few questions about your health history and briefly explain the procedure. You will be asked to remove your clothing from the waist down (your doctor or nurse will leave the room while you undress) and lie on the examination table with your legs covered with a sheet. You can rest your legs on the foot supports to help make you more comfortable during the exam.
The procedure will start with an examination of your vulva (the outer lips of your vagina). Then a metal or plastic speculum will be inserted into your vagina. You may feel some pressure. It helps to relax your stomach and leg muscles, and the muscles around your vagina so that the speculum can slide in easily. Taking deep breaths can also help the muscles in your body to relax. The Pap test should not be painful, but if you do feel any pain, be sure to let your doctor or nurse know.
The speculum opens the walls of your vagina enabling the doctor or nurse to examine your cervix.
A sample of cells is then collected from the surface of your cervix using a spatula and cytobrush. The cells will be placed on a glass side. After the test is performed, the speculum will be removed. The cells are then sent to the laboratory to be examined.
Where can I go for a Pap test?
Ask your doctor or nurse, or contact your local health centre for a Pap test. To find out where you may be able to have a Pap test in your community, call CervixCheck or click on "Where can I go for a Pap test?" on the left-hand menu.
How accurate is a Pap test?
In Manitoba, the Pap test is the most effective method for finding abnormal changes on the cervix. The Pap test, however, is not perfect. In order to increase the effectiveness of the Pap test, it is important to get screened every two years.
Does the Pap test check for sexually transmitted infections (STIs)?
No, the Pap test does not check for sexually transmitted infections. This requires a separate test.
