Everything You Need to Know about Pap Smears

Most women are accustomed to having a Pap smear as part of their regularly gynecological checkup. The Pap smear, or Papanicolaou test, looks for abnormal changes on the cells of the cervix (the narrow, lowest part of the uterus) that may indicate cervical cancer.

Pap Smear Test

During a Pap smear, your physician inserts a tool called a speculum into your vagina to widen it. He then collects a sample of cells from your cervix, "smears" them on a slide, and sends them to a laboratory where an expert will check them under a microscope. If your Pap smear is abnormal (dysplasia), your doctor may perform a biopsy for further testing or recommend an additional procedure to remove the abnormal cells. Women in their 20s and 30s often have abnormal Pap smears.

As with any medical procedure, there are risks associated with Pap smears. False negatives can cause physicians to miss cancerous or pre-cancerous cells. False positives may trigger unnecessary biopsies or medical procedures.

Cervical Cancer

Cervical cancer is the second most common cancer in women. White women between 45 and 70, and black women over 79, are most at risk. Cervical cancer generally produces few symptoms; however, it grows slowly, which makes regular screening effective at detecting cancer in the early stages. HPV (Human Papillomavirus) infection is the primary cause of cervical cancer. The HPV, spread through sexual contact, is actually common. Usually the body heals the infection on its own and most women never even know they were infected.

There are other risk factors for cervical cancer, including giving birth to many children, having many sexual partners, becoming sexually active at a young age, smoking, using oral contraceptives, having a weakened immune system, and contracting HIV.

New Screening Recommendations

In November 2009, the American College of Obstetricians and Gynecologists (ACOG) issued revised screening guidelines for Pap smears, which will result in fewer screenings and subsequent medical procedures. ACOG now recommends women have their first Pap smear at 21, regardless of their sexual history. Women under 30 should have a Pap smear every two years, unless they have other risk factors or an abnormal Pap smear. After 30, woman can reduce screening to every three years if they've had three consecutive negative smears. Once women reach 65, they may discontinue Pap smears if they've had three consecutive normal Pap smears and no abnormal results within the previous 10 years.

Fortunately, deaths from cervical cancer have declined significantly and physicians credit Pap smears for this good news.


The National Cancer Institute. "Cervical Cancer: Screening and Testing." Web. 19 May 2010.


National Cancer Institute. "Pap test." Web.


Kaunitz, Andrew M. MD. "New Pap Smear Guidelines from ACOG." Medscape Ob/Gyn & Women's Health. Web. 30 November 2009. http://www.medscape.com/viewarticle/712993