What is a PAP Smear?

What is a PAP Smear?

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that’s at the top of your vagina.

Why Do We Need a Pap Smear? 

A Pap test is done to look for changes in the cells of the cervix. Finding these changes and treating them when needed will greatly lower your chance of getting cervical cancer. 

The Pap smear test was developed by and named after Dr. George Papanicolaou for the purpose of early identification of cervical cancer. Soon after its introduction, the Pap smear proved effective at detecting precancerous lesions, which represent early — and still very treatable — indicators of cervical cancer risk.

How Often Should You Get a Pap Smear? 

This all depends on your age (and reproductive history), but generally women aged:

21-29 – every 3 yrs

30-64 – every 5 yrs if PAPs are normal

65+ – no more paps!

Preparing for a PAP Smear

If you have had problems with pelvic exams in the past or have experienced rape or sexual abuse, talk to your doctor about your concerns or fears before the exam.

No other special preparations are needed before having a Pap test. For your own comfort, you may want to empty your bladder before the exam.

Tell your doctor whether you have had an abnormal pap test in the past.

What to Expect at a PAP Smear 

You will feel more comfortable during your Pap test if you are relaxed. Breathing deeply may help. Holding your breath or tensing your muscles will increase your discomfort. You may feel some discomfort when the speculum is inserted, especially if your vagina is irritated, tender, or narrow. You may also feel pulling or pressure when the sample of cervical cells is being collected.

The Pap smear is an easy and reliable test to perform and the procedure takes only minutes to perform. So if this is your first Pap smear and pelvic exam, relax, here is the procedure, step by step.

First, you will be asked to disrobe from the waist down and put on a hospital gown or sheet over your body. Then, when instructed, you place your feet in the stirrup-style foot rests and lie back on the table (like the women in labor depicted on TV or movies). The doctor will ask you to separate your thighs and stay calm so the muscles are relaxed. The more relaxed and dropped apart your legs remain, the more comfortable you will be and the quicker the procedure will go. (If you wiggle your toes it is a great way to reduce tension in the legs, groin, or buttocks.)

With a gloved hand the examiner will touch the exterior of the vulva to separate the labia (vagina lips) and take a look to make sure it’s all normal. To widen the opening of your vagina a speculum, which is similar to a tampon applicator with a handle, is then gently inserted into vagina. There are different sizes and styles of speculums used for different women. The speculum allows the clinician to view the vaginal walls and the cervix. The cervix is located high up in the vagina. It resembles a mini bagel projecting into the vagina.

When the speculum is in place, the clinician will collect a sample of tissue from the exterior of the cervix (ectocervix) with a tool described as a spatula, then another from the cervical canal to the womb (endocervix) with a brush like instrument called a cytobrush. This process may cause some discomfort in women, especially if you are close to your period or are experiencing a vaginal infection.

The speculum is then removed; at this point the doctor usually performs a quick bimanual examination, where she or he feels the uterus and ovaries as is possible with their skillful hands — placing two fingers of one hand within the vagina and the other hand on the lower belly. Then your doctor will press gently to feel what cannot be seen. 

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