Image of plastic vaginal speculum used for pap smear test

What does a Pap smear test for?

Medically reviewed by Neka Miller, PhD on February 11, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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While Pap smears are supposed to be a quick test, some women still dread getting the screening. A cold, metal tool clamps open your vagina while a physician takes a swab of your cervix cells—so, understandably, it can be an uncomfortable experience for many. But did you know Pap smears are an important part of women's health screenings and can potentially be life-saving?

Here, we take a look at what Pap smear tests are used for, when you should get one, and what it means if your results come back abnormal, so read on to learn more.

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What does a Pap smear test for?

The Pap test, also known as the Pap smear, is a cervical cancer screening test administered by a healthcare provider. The test can detect abnormal cells in your cervix that may turn into cancer if they’re not treated.

During the Pap test, the physician administering the test will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps them examine the vagina and the cervix, and collect a few cells and mucus from the cervix and surrounding areas. The cell samples are then sent to a lab for testing.

While Pap tests and HPV tests have the same collection method and are often done at the same time, they test for different things:

  • A Pap test checks your cervical cells to see if they look normal
  • An HPV test assesses cervical cells to check for human papillomavirus (HPV) using DNA sequencing technology. HPV is a kind of sexually transmitted infection (STI or STD), and certain types of HPV are linked with a high risk of cervical cancer. So if high-risk HPV types are discovered by the test, this means a significantly higher risk of cervical cancer.

Can a Pap smear detect STDs?

No, a Pap test only checks for cell changes and potentially cancerous cells in your cervix. However, an abnormal Pap test result could indicate that you may have human papillomavirus (HPV), which is an STD that’s associated with a high risk of cervical cancer. That’s because a Pap smear checks for precancerous cell changes, or abnormalities, on the cervix that might become cervical cancer if they are not treated appropriately. These cell changes are often caused by HPV.

So, while Pap tests do not directly check for STDs, if you have abnormal Pap test results your healthcare provider may follow up with an HPV test to confirm whether you have this particular kind of STD.

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What does an abnormal Pap smear mean?

If your Pap smear results come back abnormal, this means that the test detected abnormally shaped cells in your sample. Abnormal Pap tests are common and are often the result of a cervical or vaginal infection unrelated to cervical cancer.

However, your healthcare provider may order additional testing to confirm the possibility of cervical cancer or remove cancerous (or precancerous) cells. These additional tests may include the following:

  • Reflex testing - This refers to using an HPV test after an abnormal Pap smear result (or vice versa). An HPV test checks for the presence of human papillomavirus (HPV), which is a kind of sexually transmitted infection (STI or STD); certain types of HPV are associated with a high risk of cervical cancer.
  • Colposcopy - A minimally invasive procedure where the healthcare provider administering the test uses a magnifying device (colposcope) to take a closer look at your cervix. If abnormal cells are found during a colposcopy, then a biopsy can be performed to determine whether these cells are cancerous or precancerous.
  • Biopsy - A small sample of tissue is removed from the cervix. A pathologist then checks this tissue under a microscope to rule out the possibility of cancer.
  • Conization - (cone biopsy or cold knife biopsy) and LEEP (loop electrosurgical excision procedure) are procedures that remove abnormal tissue from the cervix. They ensure that no cancerous cells are in the cervix while removing any precancerous cells that are found.

If cancerous or precancerous cells are found in your sample, your physician may recommend a treatment plan based on your age and the degree of abnormality.

Are Pap smears necessary?

According to the Centers for Disease Control and Prevention (CDC), cervical cancer can usually be prevented if women are screened regularly with a Pap test—so, yes! For many women, Pap smears are necessary and very important for health.

Pap tests can be life-saving because they can find cervical cancer cells early. The chance of successful treatment of cervical cancer is very high if the disease is caught early.

According to the CDC’s cervical cancer screening recommendations, women and menstruating individuals between ages 21-29 years should undergo a Pap smear every three years. Those between 30-65 years should get a Pap smear every three years, HPV testing every five years, or a combination of these two tests every five years (co-testing), depending on your healthcare provider’s recommendation (and if results are normal).

If you want to check for HPV without the waiting rooms or clinic visits, you can now screen for high-risk HPV genotypes from the comfort of your home. The Everlywell HPV Test allows you to collect your sample at home, send it to a CLIA-certified lab for testing, and receive your digital results in days. From there, you can choose to share your results with your healthcare provider to follow up and discuss next steps.

How to prevent HPV: here’s what you can do

HPV vs. herpes: what's the difference?

What does an abnormal Pap smear mean?

References

1. What Should I Know About Screening? Centers for Disease Control and Prevention. URL. Accessed February 11, 2021.

2. What Do My Cervical Cancer Screening Test Results Mean? Centers for Disease Control and Prevention. URL. Accessed February 11, 2021.

3. Pap smear. Mayo Clinic. URL. Accessed February 11, 2021.

4. Abnormal Pap Smear Follow-up. Roswell Park. URL. Accessed February 11, 2021.

5. Abnormal Cervical Cancer Screening Test Results. American College of Obstetricians and Gynecologists. URL. Accessed February 11, 2021.

6. Colposcopy. Mayo Clinic. URL. Accessed February 11, 2021.

7. Cone biopsy. Mayo Clinic. URL. Accessed February 11, 2021.

8. VPD Surveillance Manual - Chapter 5: Human Papillomavirus. Centers for Disease Control and Prevention. URL (PDF). Accessed February 11, 2021.

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