Robert Wood Johnson University Hospital
 

PAP Test

PAP Test

(Pap Smear, Pap Screening, Papanicolaou Test)

Procedure overview

What is a Pap test?

A Pap test, named after Dr. George Papanicolaou who designed the test, is a screening test to collect and microscopically examine cells taken from the cervix, the lower, narrow part of the uterus (womb) located between the bladder and the rectum. The cervix forms a canal that opens into the vagina, which leads to the outside of the body. With a Pap test, cells can be collected from the vagina as well as the cervix.

Who should have Pap tests?

Women should seek expert medical advice about when they should begin screening, how often they should be screened, and when they can discontinue cervical screenings, especially if they are at higher than average risk of cervical cancer due to factors such as HIV infection.

According to the American College of Obstetrics (the College), general guidelines include:

Other related procedures that may be used to diagnose cervical conditions include colposcopy, cervical biopsy, and loop electrosurgical excision procedure (LEEP). Please see these procedures for additional information.

What are female pelvic organs?

The organs and structures of the female pelvis are:

Illustration of the anatomy of the female pelvic area
Click Image to Enlarge

Reasons for the procedure

A Pap test, along with a pelvic examination, is an important part of a woman's routine healthcare because it may detect abnormalities that can lead to invasive cancer. Most cancers of the cervix can be detected early if women have Pap tests and pelvic examinations regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early.

The Pap test is useful for detecting not only cancerous cells, but also other cervical and vaginal abnormalities including dysplasia (precancerous cells) and inflammation.

A Pap test may be used to diagnose and assist in the treatment of the following conditions in the cervix or vagina:

The HPV test is often done at the same time and sometimes in combination with the Pap test.  Infection with HPV is the most important risk factor for the development of cervical cancer in women over age 30.  The types of HPV that are most likely to cause cervical cancer can be identified by the presence of their DNA in cervical cells. The HPV test may also be used for any woman with abnormal Pap test results to determine the need for additional testing or treatment.

There may be other reasons for your doctor to recommend a Pap test.

Risks of the procedure

Patients who are allergic to or sensitive to latex should notify their doctor.

If you are pregnant or suspect that you may be pregnant, you should notify your health care provider.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your health care provider prior to the procedure.

Certain factors or conditions may interfere with a Pap test. These factors include, but are not limited to, the following:

Before the procedure

During the procedure

Illustration of a Pap test
Click Image to Enlarge

A Pap test may be performed in a health care provider’s office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your health care provider’s practices.

Generally, a Pap test follows this process:

  1. You will be asked to undress completely or from the waist down and put on a hospital gown.
  2. You will lie on an examination table, with your feet and legs supported as for a pelvic examination.
  3. Your health care provider will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
  4. For the Pap test, cells will be gently removed from the cervical tissues and from the back of the vagina by using an endometrial brush, swab, or small wooden spatula. The cells will then be placed into a vial of liquid or smeared on a glass microscope slide.
  5. If the HPV test is needed, a sample of cells will be collected for this test as well.
  6. If you have symptoms of a vaginal infection, vaginal secretions may be collected for testing.
  7. Usually, your health care provider will perform a pelvic examination after the Pap test.
  8. The Pap test specimen will be sent to a lab for further study.

After the procedure

You may rest for a few minutes after the procedure before going home. Because scraping the cervix may cause a small amount of bleeding, you may want to wear a sanitary pad for any spotting that may occur.

Notify your health care provider if you have any of the following:

Pap test results usually take a few days. Ask your health care provider how you will be notified of results.

Your health care provider may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American College of Obstetricians and Gynecologists

American Society for Colposcopy and Cervical Pathology

National Cancer Institute (NCI)

National Institutes of Health (NIH)

National Library of Medicine

National Women's Health Information Center

 

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