NIH Publication No. 07-6278

Printed September 2007

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Cancer Institute

Pap Tests

Things to Know

Things to remember: 

✔ A Pap test is a simple test that checks for cell

changes in the cervix that could become cancer.

✔ Although you may feel healthy, abnormal 

changes can appear without any symptoms. 

That is why it is important to get Pap tests regularly.

✔ You should get a Pap test every 1 to 3 years.

Depending on your results, your doctor or nurse 

may suggest getting tested more often.

✔ Abnormal Pap test results do not mean that you

have cancer. It may only mean that your doctor or

nurse needs to do more tests.
A simple test can help prevent cervical cancer. 

It is called the Pap test (or Pap smear). The 

Pap test looks for abnormal changes in the

cells of the cervix. 

Where is the cervix?

The cervix is the narrow, lowest part of the uterus. 

It forms an opening between the uterus (where the baby

grows when a woman is pregnant) and the vagina. 

What causes cervical cancer?

Almost all cervical cancer is caused by an infection

from a virus called HPV or human papillomavirus

(pronounced pap-ih-LO-ma-VYE-rus). 

HPV infection is very common and is spread through

sexual contact. Most people don’t know they have HPV

because they have no symptoms. 

Most HPV infections go away on their own, but some

may not. If HPV does not go away, it can cause cell

changes. The Pap test can find these changes before

they become cervical cancer.

Prevent cervical cancer—

have Pap tests regularly. 

What is a Pap Test?

The Pap test is a simple and routine way to find cell changes.

During a Pap test the doctor or nurse will collect a few cells from

your cervix to send to a medical lab for testing. You can get the Pap

test at your doctor’s office, clinic, or community health center. 

Why should I have a Pap test?

Sometimes cells in a woman’s cervix begin to change and look

abnormal. These abnormal cells may not be cancer yet. But if you

don’t have the cell changes treated, the changes may become cancer.

Having Pap tests regularly gives you the best chance of finding cell

changes or cervical cancer early, when they are easy to treat.

The Pap test checks for cell changes caused by HPV that could

become cancer. The Pap test does not detect many sexually

transmitted diseases (STDs). Talk with your doctor or nurse about

whether you should be tested for STDs.

When should I have a Pap test? 

■ Have your first Pap test about 3 years after the first time you

have sex, or when you reach age 21 (whichever comes first). 

■ Keep getting Pap tests every 1 to 3 years. If you are 30 or older,

an HPV test may be done along with the Pap test.

■ Talk with your doctor or nurse about whether and when you

should get a Pap test if you are 65 or older.

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If cell changes are found early 

and treated, cervical cancer 

can be prevented.

Talk with your doctor or nurse about how often

you should have a Pap test.
What should I expect with a Pap test? 

BEFORE the Pap test

For two days before your Pap test, do not douche or use any

vaginal medicines, spermicidal foams, creams, or jellies unless

directed by your doctor. If you have heavy bleeding from your

period the day of the test, call your doctor or nurse to change the

appointment to another day.

DURING the Pap test

A female staff member will be with you during the test. Your hips

and legs will be covered. Your doctor or nurse will use an instrument

called a “speculum” to open the vagina and see your cervix. Your

doctor or nurse will then collect some cells from the cervix using a

swab or a small brush. You may feel some discomfort. 

AFTER the Pap test

Your doctor or nurse will send the cells to a medical lab. The results

will come back to your doctor or nurse in 1 or 2 weeks.

■ If the test results are normal (or “negative”), your doctor’s office

may not notify you at all. If you do not hear from your doctor’s

office, you should call to be sure that the results are normal.

■ If there is something abnormal on the test (or “positive”), your

doctor should tell you. It is very important that you see your

doctor for follow-up as soon as possible. Most times, an

abnormal (or “positive”) test does not mean that you have

cancer. It only means that your doctor needs to do more tests.

Be sure to follow up with your doctor or nurse 

on all test results.

When talking

with your doctor 

or nurse, be 

sure to:

■ Mention your results 

of previous Pap tests,

especially if they 

were abnormal.

■ Ask questions if there 

is something that is 

not clear to you.

Most abnormal cell changes do not cause any symptoms in the

beginning. That is why it is important to get a Pap test and to

follow up with your doctor or nurse. Depending on the results of

your Pap test, your doctor or nurse may do an HPV test. 

A note about HPV 

HPV is a virus that is spread through sexual contact. Condoms do

not fully protect against HPV. You can be infected with HPV and

not know it because there are no symptoms. Most HPV infections

go away on their own, but some may not. The infections that do

not go away can lead to abnormal cell changes in the cervix.

Having Pap tests regularly can find these changes early and 

prevent cervical cancer. For more information about HPV, read

Understanding Cervical Changes (see page 5 on how to order). 

Did you know that an HPV vaccine is available to girls and young

women? This vaccine has been shown to protect against some of

the HPV types that cause cervical cancer. Ask your doctor about the

HPV vaccine. Even if you get the vaccine, you will still need to

have Pap tests regularly.

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When can I stop getting a Pap test? 

■ If you are 65 or older, talk to your doctor or nurse about

whether or not you should keep having Pap tests. Your doctor

or nurse will tell you how often you should get one. This will

depend on the results of your previous tests, and whether you

are sexually active.

■ A total hysterectomy (pronounced hiss-ter-EK-toe-mee) is when

both the uterus and cervix have been taken out. If you had a

hysterectomy to treat pre-cancer or cancer, you should continue

to have Pap tests. If you had a total hysterectomy that was not

done to treat pre-cancer or cancer, you do not need a Pap test.

Talk with your doctor or nurse if you are not certain.

What if I can’t afford a Pap test? 

■ Free and low-cost tests: If you have a low income or do not

have health insurance, there may be places in your community

where you can get a Pap test for free. For more information 

on where to get a free or low-cost Pap test, call toll-free 

1-800-4-CANCER (1-800-422-6237). It is possible to speak 

to someone in English or Spanish.

■ Medicaid: If you are eligible for Medicaid, you might not have

to pay for the doctor visit and the Pap test. For more

information, call your state Medicaid office.

■ Medicare: If you are 65 years of age or older, Medicare pays 

for the Pap test every 2 years, or every year for certain 

women at higher risk. For more information, call toll-free 

1-800-MEDICARE (1-800-633-4227). It is possible to speak 

to someone in English or Spanish. 

For more information 

National Cancer Institute (NCI)

Cancer Information Service

Offers information on cancer prevention and screening. Responds

to questions about cancer and to requests for free publications.

Toll-free: 1-800-4-CANCER (1-800-422-6237) 

in English or Spanish

TTY: 1-800-332-8615

Web Site: www.cancer.gov 

En Español: www.cancer.gov/espanol

Chat online: www.cancer.gov/help

Free booklets that are available in print and online at

www.cancer.gov/cancertopics/screening/cervical include:

■ Understanding Cervical Changes

Provides information on abnormal Pap test results, follow-up

tests, and treatment options.

■ Cervical Cancer: What You Can Do to Protect Yourself

Provides information on Pap tests in Spanish and English.

■ Cervical Cancer: What Vietnamese Women Should Know

Provides information on Pap tests in Vietnamese and English.

■ What You Need To Know About Cancer of the Cervix

Provides information on symptoms, diagnosis, and treatment

of cervical cancer.

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Pap Test Reminder

Talk with your doctor or nurse about how often you should

have a Pap test. 

My next Pap test should be on:___________________________