The Pap Test: What It Finds and What to Expect

A Pap test — also called a Pap smear — collects a few cells from the cervix, the lower end of the uterus, and checks whether they look normal. Its main job is to find early cell changes, sometimes called precancers, before they have a chance to turn into cervical cancer.

MedlinePlus says cervical cancer develops very slowly, so repeat Pap tests usually find changes in time for treatment. CDC says the Pap test looks for precancers, cell changes that might become cervical cancer if they are not treated.

The Pap test looks for cell changes early, before they might become cancer.

The test is quick and done in a doctor's office or clinic. Here is what to expect:

• You lie back on an exam table
• The doctor gently inserts a smooth instrument called a speculum to see the cervix
• A soft brush or small spatula collects a few cells from the cervix
• The sample is sent to a laboratory

The whole thing takes just a few minutes. MedlinePlus says a Pap test causes only mild discomfort for most people, often like menstrual cramps. You may feel some pressure. You may bleed a little after the test.

A Pap test is a short office procedure.

MedlinePlus says to tell your provider if you have had an abnormal Pap or HPV test, or might be pregnant. Do not do these for 24 hours before the test:

• Douche (MedlinePlus says douching should never be done)
• Have intercourse
• Use tampons

Try not to schedule your Pap test for when you have your period. If you have unexpected bleeding, do not cancel. Your provider will decide if the test can still be done. Ask your office if it has other instructions.

Your Pap result will fall into one of a few categories. Ask your office how and when you will get results.

• Normal (negative). No abnormal cells were found. MedlinePlus says the Pap test is not 100% accurate, so repeat testing is recommended over time.
• Unclear. Cells look like they could be slightly abnormal, but it's not certain why. This is sometimes called ASC-US, equivocal, or inconclusive. MedlinePlus says mild changes may be due to HPV infection, inflammation, or low estrogen.
• Abnormal. Cell changes were found. This does not mean cancer was found. Your provider will tell you what follow-up you need.
• Unsatisfactory. The sample could not be read well. Your provider will tell you when to repeat the test.

An abnormal Pap result is a reason to follow up, not a cancer diagnosis.

If your Pap result is unclear or abnormal, your doctor will guide you on next steps. That might mean:

• An HPV test to see if the changes are linked to the virus
• A repeat Pap or combined test in a set time frame
• A closer look at the cervix with a procedure called a colposcopy

The right next step depends on your specific result, your age, and your past screening history. Follow up as your provider recommends.

An abnormal or unclear result is a signal to follow up.

CDC's National Breast and Cervical Cancer Early Detection Program helps women with low incomes get cervical cancer screening. Your care team or local health department can help you find out whether you qualify.

If cost is a barrier, ask about screening programs for people with low incomes.

The Pap test itself rarely causes anything beyond brief discomfort or a little spotting. These signs matter most in the days after a colposcopy or cervical biopsy done to follow up an unclear or abnormal result.

• Call 911 or go to an emergency department if bleeding is very heavy and will not stop, or you feel faint or dizzy with it. Do not drive yourself.
• Call your care team right away, day or night, if bleeding is very heavy or lasts longer than 2 weeks, you have pain in your belly or pelvic area, or you have signs of infection such as fever, a foul odor, or discharge. MedlinePlus says to contact your provider right away for these.

Sources: MedlinePlus — Colposcopy (warning signs), MedlinePlus — Pap smear, CDC — Screening for Cervical Cancer, NCI — Cervical Cancer Screening, and CDC — NBCCEDP.