Pap tests and checkups

What's a Pap test and why is it so important?
A Pap test, also called a Pap smear, is a simple test that can help your doctor check the cells on your cervix (the lower part of your uterus) to detect abnormal cervical cells before they have a chance to develop into cervical cancer. This helps catch cervical cancer while it's still early and easy to treat.

How is a Pap test done?
A Pap test is usually done during a pelvic exam, when your doctor checks to make sure the parts of your reproductive system (such as the vagina, uterus, and ovaries) are healthy and also screens for other sexually transmitted infections (STIs).


Female reproductive system

Pap test procedure

Although it may sound a little scary, it's really not that bad at all. During the Pap test, your doctor will insert a device (called a speculum) to hold your vagina open just enough for him or her to insert a small stick-like instrument. Some cells are scraped off your cervix (which you'll barely feel) and are then smeared on to a slide. This slide is sent off to a lab for examination.

The test doesn't take very long, typically only a couple of minutes, and it shouldn't hurt, although you could feel some pressure while the cells are being removed. You may also experience a bit of light bleeding after the test. If you're feeling uncomfortable about having a Pap test, ask a friend or family member to come with you to the doctor.

When should I have my first Pap test?
In Canada, it is recommended for most women to begin Pap test at age 25, and usually at regular intervals every 3 years thereafter until the age of 70. If symptoms of cervical cancer are present, if the previous screening results are abnormal, or if you are immunosuppressed, the recommendations do not apply. However, each province has slightly different guidelines for start time and frequency of Pap tests, so it is important to check with your doctor.

Women who have been vaccinated against some types of HPV still must have regular Pap tests, since the vaccine doesn't prevent all types of HPV infection. The Pap test is the only way to know if you have abnormal cells.

Don't put off your Pap tests. According to recent statistics, up to 50% of women with cervical cancer didn't get their Pap tests as recommended. Cervical cancer can be treated much more successfully if caught early. A Pap test can do just that.

If the doctor says the results of your Pap test are abnormal, it doesn't necessarily mean you have cancer. Every year, about 4 to 5 million Pap tests are done in Canada and about 350,000 of them show abnormal results. The Pap test detects changes in the cervical cells. An abnormal Pap test may mean changes in the cells of the cervix for a variety of reasons, including vaginal infection, other STIs, or hormonal changes. Sometimes, an abnormal result may just mean the sample taken from your cervix was not adequate.

Depending on the type of abnormal result, your doctor may repeat the Pap test, treat any infection, or perform further tests. Some physicians may choose to take a "wait and see" approach along with more frequent Pap tests for mild cases of cervical dysplasia, as these cases may go away on their own. It can be scary to be told you have an abnormal Pap result - remember that most women with an abnormal Pap result do not have cancer.

Talk to your doctor about when you should have a Pap test, and about other ways to protect yourself from HPV infection.