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You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world's leading professional organization for doctors that care for people with cancer.

Today we’ll talk about what to expect when you have a Pap test. 

Doctors use a Pap test--also called a Pap smear--to check for abnormal cells in the cervix, which is part of a woman’s reproductive system. The cervix is the part of the uterus that opens to the vagina.

This podcast will explain what happens during a Pap test and offer a list of questions to ask the doctor about your test and its results.

A Pap test is usually performed as a routine screening test for cervical cancer in women who have no symptoms. It’s typically done as part of a gynecologic checkup. Although a Pap test can detect cervical cancer, it also finds early changes in the cells in the cervix that, if not treated, could turn into cancer. If the Pap test finds an abnormality, it’s most commonly related to treatable, precancerous cellular changes, rather than cervical cancer.

A Pap test is performed in your doctor’s office, generally by a gynecologist. A gynecologist is a doctor who specializes in women’s reproductive health. If your gynecologist is a man, a female nurse or assistant will be in the room during the examination and Pap test. Other health professionals who can perform a Pap test include physician assistants and nurse practitioners.

The best time to schedule your Pap test is at least five days after the end of your menstrual period. A Pap test can be done during your menstrual period, but it’s better to schedule the test at another time. Also, don’t have sexual intercourse for two or three days before the appointment, and during that time, avoid tampons, vaginal foams, medicines, douches, creams, or powders. These steps will help make sure that the Pap test results are as clear as possible.

When you arrive at the doctor’s office on the day of the test, you may be asked some basic questions, such as whether you are pregnant, whether you use birth control and what type, what medications you’ve recently taken, if you smoke, and whether previous Pap tests have ever found a problem. You will also be asked about the date and length of your last menstrual period, whether you are experiencing any problems such as redness or itching, and if you’ve had any surgery on your reproductive system.

When you enter the examination room for the Pap test, you will be asked to undress from the waist down and to cover your lower body with a sheet.  You’ll lie down on your back on an examination table, raising your legs and putting your heels in stirrups at the end of the table. You can keep your socks on to keep your feet warm.

Next, the doctor will carefully insert a lubricated instrument--called a speculum--into your vagina. As it gently spreads the vaginal walls apart, you may feel some discomfort. Breathe deeply and relax your muscles to help relieve the discomfort.  

Then, the doctor will visually examine the cervix through the speculum. With a cotton swab or other small instrument, some cervical cells will be collected from two places in the cervix. As the cells are collected, you may feel slight pulling or pressure. The swab and speculum will then be removed. The cells will be smeared onto a slide or stored in a container for shipment to a lab, where another doctor--called a pathologist--will study them for any abnormalities.  

The Pap test itself takes just a few minutes. It can be uncomfortable, but it seldom causes any pain. Having an empty bladder may help you feel more comfortable during the examination. After the Pap test, the doctor will often perform a pelvic exam. He or she will put two lubricated, gloved fingers inside your vagina and use the other hand from the outside to feel for lumps or tenderness in your reproductive organs, including your ovaries and uterus.

When the examination is complete, you may have some vaginal bleeding. This is normal, but tell your doctor about any heavy bleeding. You can resume all your normal activities, including driving, after the examination.

The Pap test is an excellent screening tool, but it’s not perfect. Sometimes results come back normal even when abnormal cervical cells are present. For this reason, it’s important to be screened regularly. Research shows that almost all cervical abnormalities can be found with regular screening and treated before they become cancerous. Talk with your doctor about how often you should have a Pap test.

Some of the cells collected from the cervix during the Pap test may also be tested for a virus called the humanpapilloma virus, or HPV. HPV is most commonly passed from person to person during sexual activity. There are different types--or strains--of HPV. Some strains raise a woman’s risk of developing cervical cancer and certain other types of cancer. Women with a history of abnormal cells and women older than thirty should receive the HPV test with a Pap test, according to current screening guidelines.

Before your Pap test, consider asking your doctor the following questions:

Question one: Who will perform the test?

Question two:  When will I get the results, and who will explain them to me?

Question three: What happens next if the results are abnormal or unclear?

Question four: After this test, when should I have my next Pap test?

Be sure to ask your doctor any other questions you may have about preparing for and having a Pap test. Knowing what to expect before the procedure may help you feel more comfortable.

For more information on screening for cervical cancer, contact your doctor or visit www.cancer.net. Cancer.Net is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high-quality cancer care. Thank you for listening to this Cancer.Net podcast.

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