How Often You Should Be Getting a Pap Test Done
As part and parcel of your standard health care, you should make sure you’re screened for cervical cancer. (1)
A Pap test or Pap smear, tests for any cells on the cervix that are either precancerous or cancerous. If any rogue cells are discovered, there’s a chance to stop them from developing into full-blown cervical cancer.
Let’s look at what’s involved when you’re getting a Pap test done, what the doctor is actually looking for and how frequently you should consider having a Pap test.
What is a Pap Test?
A Papanicolaou test, routinely abbreviated to Pap test, has 3 core functions:
- Screen for precancerous cells in the cervix
- Diagnose precancerous vaginal conditions
- Diagnose inflammation in the reproductive tract (2)
It’s best to avoid going for a Pap test while menstruating. The test should optimally be carried out mid-cycle.
Tests only take a few minutes and, while you may experience a little discomfort, you shouldn’t find the procedure painful.
In order to properly see the upper portion of the cervix, the doctor will insert a speculum into the vagina.
Using a small spatula, the doctor very gently scrapes the cervix to collect cells.
Sometimes, cells are also taken from the inner cervix along with tissue from the vagina.
These cells are then popped onto a slide or, more commonly now, rinsed into a container containing a special solution.
Once this is done, what exactly is your doctor looking for?
What Is The Doctor Looking For?
Almost all cases of cervical cancer are caused by HPV, varieties of the human papillomavirus. (3)
Often, for women aged 30 and above, Pap testing is done at the same time as HPV testing.
A cytologist will examine the cells to determine if there are any precancerous or cancerous cells.
Your doctor should receive the results within a few days and he’ll then be able to interpret them for you.
- Negative/Normal: This shows that the cervix is healthy and all cells are the size and shape they should be.
- Positive/Abnormal: An abnormal result points to cells that are not of the expected shape or size. (4)
If the results indicate any kind of abnormal finding, this does not automatically mean you have cancer.
In this case, you’ll require follow-up tests in order to establish firmly what the problem is.
What Is The Bethesda System?
Most US-based labs report findings of Pap tests using the standardized Bethesda system.
We don’t want to blind you with a battery of technical terms and analyzing the full extent of this system falls outside the scope of this brief overview. Check out this article for a more detailed breakdown of the specifics of the Bethesda system. (5)
Now you know what your doctor is looking for and what will happen during the course of a Pap smear, the all-important question is how often should you be getting this screening done?
How Often You Should Be Getting It Done
Different countries offer different guidelines when it comes to cervical screening so we’re going to look at Canada and the US where there are slight variations.
You should check closely for the recommendations of your particular state or province. With all aspects of your healthcare, it pays to take the time and trouble to educate yourself fully.
For Canada, we’ll use British Columbia as an example. For women aged between 25 and 69, screening is recommended every 3 years. (6) This resource gives you some great information and also helps you to find the nearest clinic.
In the US, screening advice is a little more elaborate.
The US Preventive Services Task Force (USPSTF) states that women aged 21 to 65 should go for screening every 3 years. (7)
For any women aged 30 to 65 who prefer longer intervals between screening, a combined Pap test and HPV test is recommended every 5 years.
The USPSTF does not recommend screening for cervical cancer in any women younger than 21. They also advise against HPV testing, either combined with a Pap test or in isolation, for any women younger than 30.
If you’re over 65 and have always made sure to undergo adequate screening, no screening for cervical cancer is recommended unless you fall under a high risk category.
Screening is not recommended for any women who have had a hysterectomy either unless they have a history of precancerous lesions.
This USPSTF page gives full details of the above summary.