When cervical cancer is found early, there’s a far greater likelihood that it can be treated successfully. It’s recommended to start having Pap smear screening at age 21.

While breast cancer is currently the leading cause of cancer death among females, cervical cancer was one of the most common causes for many decades.

Pap smears first became available in the 1950s. Researchers estimate that cancer screenings — which often include a Pap smear — are associated with a 70% reduction rate in the incidence of cervical cancer and the outlook for people with it since that time.

A Pap smear, also called a Pap test or cervical smear, tests for abnormal cells in your cervix. Pap smears can also identify vaginal infections and inflammation. They’re mainly used to screen for cervical cancer, which is most common in people older than 30 years of age.

It’s important to note that a Pap smear isn’t the same as a human papillomavirus (HPV) test. HPV tests are usually used for those who are ages 21 years and older with abnormal Pap smear results and those who are ages 30 years and older. Sometimes, an Obstetrics and Gynaecology (OB-GYN) doctor may combine the two tests if you’re due for both.

Experts have established a schedule for when and how often people should have a Pap smear. Read on to learn more.

The U.S. Department of Health and Human Services provides the following recommendations for Pap smears for those with no known risks.

Age (years)Pap smear frequency
<21not needed
21–29every 3 years
30–65every 3 years, or an HPV test every 5 years, or a Pap test and HPV test together (called cotesting) every 5 years
65+Talk with a doctor; you may no longer need Pap smear tests.

What if I’ve had a hysterectomy?

Ask a doctor if you need to continue having Pap smears. Usually, the tests can be stopped if your cervix was removed during your hysterectomy and you have no history of cervical cancer.

To increase the accuracy of your Pap smear, there are several things you should avoid for about 48-72 hours before the test. They include:

If possible, you should also avoid being tested while you’re menstruating.

When you have a Pap smear, you’ll be asked to lie back on the examination table with your knees up. You’ll place your feet in stirrups on each side of the table. You’ll need to scoot your bottom to the end of the table.

The doctor will place a metal or plastic speculum in your vagina to hold it open. They’ll then use a swab to lightly scrape off some of the cells and mucus on your cervix.

Most people don’t experience pain during the test, but you may feel a slight pinching, pressure, or period-like cramping. This is usually temporary and will go away after the procedure.

The doctor will send your samples to a lab for evaluation under a microscope. If necessary, the doctor may also order an HPV test.

The Pap smear is intended as a screening test that alerts the need for further examination. It’s considered a reliable test. Routine Pap smear screening is very good at detecting cervical cancer. But there are instances of false-negative and false-positive results, as outlined in a 2017 study.

There are different types of Pap test results. Most Pap smear test results come back with a negative result. This means you’ve tested negative for abnormalities and should continue to follow the recommended schedule for future tests.


Sometimes Pap smear test results come back as unsatisfactory. This isn’t necessarily a cause for alarm. It can mean several things, including:

  • Not enough cervical cells were collected to perform an accurate test.
  • Cells couldn’t be evaluated because of blood or mucus.
  • An error in administering the test.

If your results are unsatisfactory, the doctor may want to repeat the test immediately or have you return sooner than the normally scheduled retesting.


Getting results that your Pap smear is abnormal doesn’t necessarily mean you have cervical cancer. Instead, it means that some cells were different from other cells. Abnormal results are also known as positive results. They usually fall into two categories:

  • Low-grade changes: This often means you have HPV. You’ll need to be monitored closely and may need a colposcopy if the changes remain after 2 years.
  • High-grade changes: This can indicate that you’ve had an HPV infection for a longer time. The cells can be precancerous or cancerous. You’ll need another Pap smear test after 6 months and then a colposcopy or cone biopsy if necessary.
  • Atypical squamous cells of undetermined significance (ASCUS): This is the most common abnormal finding in a Pap smear. It indicates low-grade inflammation from infections or irritation from an intrauterine device (IUD). Since it’s not clear whether this result is caused by HPV, you’ll need an HPV test. If you test positive, the doctor will refer you to a colposcopy. If you test negative, you’ll have to have additional Pap smears depending on your age and other guidelines.

When changes occur in the structure of cells of your cervix, which is the lower part of your uterus that connects to your vagina, they’re considered precancerous. These precancers can usually be removed in a doctor’s office using liquid nitrogen, an electric current, or a laser beam.

In a small percentage of people, these precancers will begin to grow quickly or in large numbers and form cancerous tumors. Untreated, cancer can spread to other parts of your body.

Different types of HPV cause nearly all cervical cancer in people. HPV may be transmitted through vaginal sexual intercourse, oral sex, or anal sex.

An HPV infection is very common. It’s so common that almost everyone sexually active will get HPV at some point.

You can contract an HPV infection if you’ve only had one sexual partner. You can also have the infection for years without knowing it.

Although there’s no treatment for infections with the types of HPV that cause cervical cancer, they usually go away on their own within 1 or 2 years.


Many people don’t have symptoms of cervical cancer, particularly pain, until it has progressed to a more advanced stage. Common symptoms include:

Certain factors put you at greater risk of getting cervical cancer. These include:

  • smoking
  • HIV
  • compromised immune system
  • having family members who received a diagnosis of cervical cancer
  • having a birthing parent who took the synthetic estrogen diethylstilbestrol while pregnant with you
  • having previously received a diagnosis of precancer or cancer of the cervix
  • having multiple sexual partners
  • being sexually active before the age of 18, which can increase a person’s chance of developing cervical cancer.

In addition to Pap smears, other cancer tests are important for females.

The doctor may recommend additional tests or other timelines depending on your medical history. Always follow the doctor’s recommendations, as they’re the most familiar with your health needs.

Do I have to get a Pap smear?

It’s highly recommended that you get regular Pap smears to screen for HPV or cervical cancer.

Can I get a Pap smear under 21?

A doctor may not recommend getting a Pap smear before you’re 21 years old unless you are in a high risk category.

Is a Pap smear painful?

You may notice some pressure on your cervix as the doctor swabs for cells during your Pap smear. But it’s very brief.

What should I wear to a Pap smear?

You can wear whatever clothing you’d wear on a typical day to your Pap smear. The doctor will ask you to remove your clothes and underwear and put on a gown for the examination.

What time of the month is best for a Pap smear?

The best time for a Pap smear is any time during the month when you’re not on your period.

Most females should start getting Pap smears around the age of 21. These tests show whether there are abnormal cells in your cervix and are an important way to screen for inflammation that may indicate cervical cancer. Pap smears have been shown to reduce the incidence of cervical cancer and the outlook for those with it by 70%.

Pap smears are usually performed by an OB-GYN and are not usually painful, though some people may feel temporary cervical discomfort. If the results indicate an abnormal result or your doctor thinks it’s necessary, you may also need to get a test for HPV.