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The Pap smear is an essential procedure that yields valuable information about a woman’s cervical health. But it’s normal to feel a little nervous about this exam—especially if you’ve never had one. Knowing what to expect can ease your mind and get you mentally prepared.
Here are some frequently asked questions about this procedure: what it is, why it’s important for your health, and what will happen at your appointment.
1) What is a Pap smear and why should I have one?
It’s a screening test to detect abnormal cervical cells which might indicate cervical cancer. In the United States, 13,800 women will be diagnosed with cervical cancer in 2020. Without this screening, the number of women being diagnosed would likely be much higher.
2) What should I expect from the procedure?
During the test, you will lie on the exam table and place your feet into stirrups. Your doctor or nurse practitioner will gently insert a device called a speculum into your vagina to open your cervix. Then, they will use a small plastic tool to take a small sample of cervical cells. Depending on your medical history and age, they may also use a swab to collect a sample for a human papillomavirus (HPV) test.
3) How long does the examination last?
It’s quick—usually just a few minutes.
4) Does the test hurt?
Although the insertion of the speculum might cause mild discomfort, the test should not hurt. I always tell my patients that by the time they get back to their car, they’ll forget they even had the procedure. (So far, no one has told me I was wrong!)
5) Can I be tested while I’m on my period?
There is no clinical reason not to be tested while on your period. However, many patients don’t feel comfortable being examined during this time. If you find you’re not comfortable with having the procedure during your period, reschedule your appointment ahead of time, if possible.
Nervous about a Pap smear? Dr. Ebony Hoskins answers questions to prepare you for this essential screening. https://bit.ly/3hongUa via @MedStarWHC @drebonyhoskins
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6) How often should I be tested?
Frequency depends on a few factors, including your age and medical history. If you’re not sure whether you need the procedure, speak to your doctor.
As a general rule, screenings begin at age 21. Women with normal screening results retest every three years until they reach 30; those with an abnormal result may require more frequent exams.
After age 30, screening may be reduced to every three to five years, depending on the patient’s history. HPV testing also typically begins at age 30. Women over 30 who have tested positive for HPV typically undergo yearly Pap smear screening, as this group is at higher risk for cervical cancer.
7) Do I need to be tested if I’ve had the HPV vaccine?
Even if you’ve been vaccinated, you still need to undergo regular screening for abnormal cervical cells and HPV. The HPV vaccine protects against several types of HPV that can cause cervical cancer and genital warts, but it can’t prevent you from contracting all strains of the virus—there are over 100 types of HPV!
Regardless of whether you’ve had the HPV vaccine, it is important to follow your doctor’s recommendations about regular screening.
8) What if my results are abnormal?
Approximately 5% of results come back abnormal. If you have an abnormal result, your doctor will likely recommend follow-up testing to rule out the possibility of pre-cancerous or cancerous cells. Depending on your age and medical history, this may simply mean repeating the procedure.
If you’ve had more than one abnormal test, you may need to undergo a diagnostic test to determine the cause. The prospect of a diagnostic test can be scary, but keep this in mind: While approximately 3 million women in the United States have an abnormal Pap each year, less than 1% of those cases eventually lead to a cervical cancer diagnosis.
The follow-up diagnostic test is called a colposcopy. Your doctor will use a speculum to open your cervix. He or she will then use a magnifying device known as a colposcope to closely examine your cervix for abnormalities. A biopsy may also be performed, depending on what the doctor sees. The procedure usually takes 10 to 20 minutes.
If you are feeling anxious about abnormal results, or if you’re worried about having a colposcopy, tell your doctor your concerns.
Your Gynecologic Care at MedStar Washington Hospital Center
If it’s determined that you have cancerous or pre-cancerous cervical cells, the staff at MedStar Washington Hospital Center is here to help.
Our multidisciplinary team of radiologists, radiation oncologists, and gynecologic oncologists can offer you the knowledge and care you need. Our door is open.
LISTEN: Dr. Hoskins discusses pap smears on the Medical Intel podcast.