What is a Pap smear test?
A Pap smear test is a quick and simple test used to check whether there are changes in the cells of the cervix (opening to the womb) that could lead to cervical cancer.
A specially designed brush or spatula is inserted into the vagina to take cells from the surface of the cervix (exo-cervix or ecto-cervix) and the cervical canal (endo-cervix).
The cells are then 'smeared' onto a slide, 'fixed' (preserved) with an alcohol spray and sent to a laboratory where a pathologist examines them under a microscope.
ThinPrep Pap smear test
A ThinPrep Pap test is a type of Pap smear test. With the ThinPrep test, a woman's cervical cells are collected in the same way as the conventional Pap smear test. The conventional Pap test slide is created and then the cells are put into a container filled with a preservative solution, which is sent to a laboratory. This technique separates cervical cells from mucous, blood and other substances in the sample.
The technique can be used to increase the number of cells for analysis if there have been:
- abnormal cells
- cells unable to be accurately assessed
- too few cells to assess, for example after menopause when the cervical cells are thin
There is an additional cost for the ThinPrep analysis and this is not covered by Medicare.
Where to get a Pap smear test
- Your doctor
- A health centre
- A family planning clinic
What to expect when you have a Pap smear test
Most women find the Pap smear test painless. The doctor will need to insert a metal or plastic object into the vagina to see the cervix. This can be a bit uncomfortable. Then the specially designed brush or spatula is inserted into your vagina to collect the cells. If the test hurts let your doctor know.
When to start Pap smear tests
All women should start having Pap smear tests from age 18-70, starting within two years of first sexual activity.
Testing should continue once every two years until the age of 70. Women over 70 years may stop Pap smear testing if they have had two normal smears in the previous five years.
This testing should continue whether or not you have sex because changes may take some years to develop.
Three out of four women who develop cervical cancer have never had a Pap smear test or had not had a Pap smear test in the five years before diagnosis.
When to have a Pap smear test
Pap smears can be done at any time of your cycle, as long as you are not bleeding.
The accuracy of the test can be reduced if you have a Pap smear test:
- during your period
- when there is a vaginal infection such as thrush
Blood or infected cells reduce the accuracy of the reading of the test.
If a test has to be repeated, it is best to wait 2-3 months before repeating it so the cells can return to normal.
Heavy vaginal bleeding
If you have heavy vaginal bleeding, you should:
- have a Pap smear test (preferably not during your period)
- ask your doctor to investigate the causes of the heavy bleeding
If you have had a hysterectomy you may need to have a smear taken from the top of the vagina once every two years, if:
- you have ever had an abnormal Pap smear test
- the hysterectomy was for cancer of the uterus (womb) or cervix
- you have had a hysterectomy where the cervix remains
If the ovaries were retained after hysterectomy, the ovaries should be checked approximately 2-5 yearly.
Accuracy of Pap smear tests
The Pap smear test is a screening tool. This means the test will not diagnose 100% of cervical cancers, but it is the best test available to prevent many cancers of the cervix. Most cancers occur in women who are unscreened.
Regular screening with Pap smear tests reduces the risk of a cancer of the cervix remaining undiagnosed. A Pap smear test taken once every two years from ages 18-70 reduces the risk of developing cancer of the cervix by up to 90%.
An abnormal Pap smear test result
An abnormal Pap smear test result means there is some change in the cells taken from the cervix.
Cervical cells turn over rapidly, regenerate and in this process can become abnormal or changed.
There are many reasons for a change or difference including:
- Pre-cancerous changes
The abnormal changes are classified according to the changes seen in the surface cells (squamous cells) of the cervix. More information on what happens when you have an abnormal pap smear test is discussed in our pages on vulva, vagina, uterus and ovaries.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at February 2014.