Pap Tests: What Do They Detect?

If you are a young woman, whether you are sexually active or not, it is important to visit a gynecologist each year. Having your female reproductive parts checked annually is important to your overall health.


When planning your first visit to a gynecologist, you might be aware that the doctor will be performing a pap test. Pap tests or smears, as they are often known, are a common test performed during your routine annual or biannual checkup. So, what is this test, what can you expect, and what does it detect? We’ve got the answers to all of your questions.


What is a Pap Smear?

A pap smear is a quick and painless test that is often used to screen for cervical cancer. During this test, the gynecologist will collect several cells from your cervix to determine if there are any abnormal changes that could possibly lead to cervical cancer. This is a way to tackle an issue before it becomes a bigger problem.


It is recommended by the American College of Obstetricians and Gynecologists that women have their first pap smear by the age of 21. If a female is sexually active, she should have this test performed sooner. If you are older than 21, it is important to your health that you visit a gynecologist to have this test performed as often as recommended by your doctor.


There are no risks to having a pap test. Following the test, a woman might have some minimal spotting.


What to Expect During Your Test

When scheduling your gynecologist appointment it is important to schedule your pap smear when you are not menstruating. It is also recommended that you do not have intercourse or use tampons 48 hours prior to your appointment. This can alter the results.


During your appointment you will be asked to undress from the waist down. You will be able to cover yourself with a sheet. The gynecologist will then ask you to lay down and place your feet in the stirrups. He or she will then use lubrication and insert a speculum to spread your cervix. A small swab will then be used to rub the cervix and take a sample of several cells.


Every patient is different, so during this procedure some may experience a little pain like menstrual cramps, but others do not feel anything. This test is done within seconds and then the sample is placed in a small tube and sent to the lab for processing.


Once your pap smear is complete the sample is sent to a lab for testing. The doctors office should receive your results within a couple of weeks. Often times the doctor will not contact you if your results are normal. However, if they are abnormal the gynecologist might require a follow-up.


What Does the Pap Smear Detect?

As previously mentioned, the pap smear detects cervical cancer and abnormal cells that could be precancerous. If the test does detect abnormal cells, it does not necessarily mean that you have cancer. You may have had slight inflammation or minor cell changes. These problems can clear up over time. However, your gynecologist might recommend that you have another pap test in several months.


If the second test still shows abnormal cells, your doctor may require you to have a colposcopy and a biopsy. During the colposcopy, the gynecologist will use a colposcope, which has a bright light and lens to get a clear look at your cervix. If the doctor doesn’t think the cells look right, he or she may take a biopsy for further testing.


Pap Smear Analysis

When the pap test is sent to a lab, a system called The Bethesda System is used to analyze the cells. By doing so, there is a standardization in the results and eliminates the possibility of different labs giving you different results.


There are four categories for an abnormal pap test. These four categories are:


  • ASC-US (Atypical Squamous Cells of Undetermined Significance), which means that the cervical cells look abnormal, but are not malignant


  • LSIL (Low-grade Squamous Intraepithelial Lesion), which is slightly more serious than ASC-US, but the cells often return to normal after a few months


  • HSIL (High-grade Squamous Intraepithelial Lesion), which is a severe abnormality, but is not cancer. This diagnosis requires immediate treatment.


  • ASC-H (Atypical Squamous Cells), which means there are abnormal cells and HSIL cannot be excluded.


Based on your results, your gynecologist will be able to determine the next steps and will discuss these steps in detail with you.


How Often Should This Test Be Performed

As a young woman having a pap smear is very important to your health. You want to stay informed and take necessary action if there are any abnormal cells in your cervix. It is recommended that women between the age of 21 and 30 have a pap test every three years. At 30 years old, women have the option of having an HPV test in addition to a pap smear. If they are both negative, then you can wait up to five years. However, if you choose to not have the HPV test, then you should still test every three years.


After 65 years old, the doctor may recommend to discontinue pap smears, especially if you have had a normal pap test over the past 10 years. However, this is something that needs to be discussed with your gynecologist.


If a doctor feels you are at high risk for cervical cancer because of medical history or previous abnormal results, he or she may recommend more frequent pap tests.



When it comes to your reproductive health, a pap test is very important. It is crucial that you have routine check-up appointments with your gynecologist to ensure you remain in good health and to take action against any abnormalities. If you have any questions about a pap test or other medical concerns, schedule an appointment with your gynecologist today. If you have not had a pap test yet, take action and schedule yours right away.

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