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You may have heard that getting a regular Pap smear is important, but you’re not sure when — or if — you need one. You may even feel confused about what a Pap smear tests for.

Here, we break down what you need to know about this potentially life-saving procedure.

What Is a Pap Smear?

The Papanicolaou test (Pap smear or Pap test) is a screening test for cervical cancer. It allows doctors to find changes in the cells of the cervix — the lower part of the uterus. These abnormal cells could eventually become cancerous.

What causes cervical cancer?

The human papillomavirus (HPV) causes cervical cancer. HPV is a virus that sometimes infects cervical cells and causes them to change. HPV gets spread through vaginal, oral, and anal sex, as well as close sexual touching.

Some other types of HPV can cause cancer of the vulva, vagina, penis, anus, mouth, or throat.

What Does a Pap Smear Test For?

A Pap smear screens for cervical cancer. It doesn’t test for sexually transmitted infections (STIs). If you think you need STI testing, you must ask your doctor for other tests.

Sometimes certain infections or inflammation can create an abnormal result on a Pap test. But the main reason to get a Pap smear is to screen for cervical cancer.

Is there another screening test for cervical cancer?

Yes. The HPV test detects the virus that causes cervical cancer. Unlike the Pap test, it doesn’t find abnormal cells. It only tells you if your body has the HPV virus.

Doctors use the HPV test alone or with the Pap test.

Why are Pap tests so important?

Regular Pap or HPV tests — along with getting the HPV vaccine —  are the best way to prevent cervical cancer from developing. Cervical cancer grows slowly and doesn’t have many symptoms in the early stages. Without these screening tests, you could develop cervical cancer and not know it until the disease was in its late stages.

According to the American Cancer Society, cervical cancer was once one of the most common causes of cancer deaths in the U.S. The rate dropped significantly when doctors began screening with the Pap smear. Nowadays, most cervical cancers occur in women who’ve never had a Pap test or haven’t had one recently.

Do I Need a Pap Test Every Year?

The short answer is probably not. In the past, doctors advised women to have a Pap test every year. But more recent research has shown that’s unnecessary for most people.

The Centers for Disease Control and Prevention (CDC) recommends cervical cancer screening at these intervals.

Ages 21 to 29: Pap test every three years.

Ages 30 to 65:

• HPV test only. If normal, wait five years before the next screening.
• HPV test with the Pap test (co-testing). If results are normal, wait five years before the next screening.
• Pap test only. If normal, wait three years before the next screening.

Older than 65: You probably won’t need a Pap or HPV test if you’ve had several normal screening tests in a row. You also don’t need screening if you had a hysterectomy.

All ages: Your doctor may recommend more frequent screenings if you had abnormal Pap tests in the past or have a weakened immune system.

Preparing for Your Pap Smear

You take a Pap test in your ob-gyn’s office. This usually happens during your annual pelvic exam. To prepare for your Pap smear:

• Avoid putting anything in your vagina for two days before your Pap test. That includes having intercourse or using douches, tampons, spermicidal foams, creams, or jellies. Any of these may interfere with test results.
• Empty your bladder before the test for greater comfort.
• Tell your doctor if you’ve ever had an abnormal Pap smear in the past or if you might have gotten pregnant.
• Try not to schedule your Pap test when you’re having your period. But if you’re having a lighter flow, you may still take the test. If you unexpectedly have your period on the day of your exam, call the doctor’s office to see if you should reschedule.

During the Pap Smear

The Pap test only takes a few minutes. You’ll lie on a table with your knees bent and your feet in footrests. Your doctor will gently insert a Pap smear tool (speculum) into your vagina.

The speculum opens slightly, allowing the doctor to see your cervix. They collect cells from your cervix with a small brush, then send the sample to a lab for testing.

Many women worry that a Pap test will hurt. You shouldn’t feel pain, but you may feel slight discomfort like menstrual cramps. Some women also feel pressure from the speculum.

You may also have a slight amount of bleeding after the test.

What Do the Results of a Pap Smear Mean?

Your doctor’s office will let you know your Pap test results. Receiving them usually takes several weeks.

Possible results include:

• Abnormal — the lab found some cell changes in your cervix, but that doesn’t mean you have cervical cancer. Minor cell changes often return to normal on their own. Your doctor may recommend further testing and treatment if the changes are more serious.
• Inconclusive — the cervical cells look abnormal, but whether this is because of HPV is unclear. You may get this result if you are pregnant, going through menopause, or have a yeast infection. Your doctor may recommend following up with another Pap test or HPV test.
• Normal or negative — your cervix showed no cell changes in the normal or negative results. But you should keep getting Pap or HPV tests in the future. Your doctor will tell you which test you should take and when you should take it.
• Unsatisfactory — meaning cells in the sample got clumped together and the test was hard to read. Your doctor may ask you to repeat the test.