Pap smear

Overview

A Pap smear (also called a Pap test) is a screening test that checks for changes in the cells of the cervix — the narrow part of the womb that opens into the vagina. It helps spot abnormal cells early, before they can become cervical cancer.

Yes, Pap smears are a standard part of cervical screening worldwide. Millions are done each year to help prevent cervical cancer.

Women and people with a cervix, typically starting around age 25 and continuing until about age 64. It is not needed for those who have had a total hysterectomy that removed the cervix or for those who have never been sexually active, unless recommended by a healthcare provider.

Symptoms

Common symptoms

• Pap smears are done when there are no symptoms — they are a preventive screening test.

Symptoms in children

• Pap smears are not performed in children. Screening begins in adulthood as recommended by national guidelines.

Symptoms in older adults

• Older adults may still need Pap smears up to age 64, following their healthcare provider's advice. After that, screening usually stops unless there are specific concerns.

Causes

Main causes

• Pap smears are a screening test, not a disease. However, abnormal results are most often caused by infection with high-risk types of human papillomavirus (HPV).

Risk factors

• HPV infection (especially high-risk types)
• Smoking
• Weakened immune system (e.g., from HIV or certain medications)
• Long-term use of oral contraceptives
• Multiple sexual partners or early onset of sexual activity

When to see a doctor

See a doctor urgently if:

• If you have heavy bleeding or severe pain in the pelvic area.

Book a routine appointment if:

• When you are due for routine cervical screening — typically every 3 to 5 years based on your age and previous results.

Diagnosis

A healthcare provider collects a small sample of cells from the cervix using a soft brush and spatula. The sample is sent to a laboratory and checked for abnormal cell changes.

Tests that may be done

• Pap smear (cervical cytology)
• HPV test (often done together with the Pap smear or as a follow-up)

What to expect at your appointment

The test is usually done at a clinic or doctor's office. You will lie on an exam table with your feet in stirrups. The provider gently inserts a speculum (a plastic or metal tool) to open the vagina, then brushes the cervix to collect cells. It lasts a few minutes and may cause mild discomfort but is not painful. You can go home right after.

Treatment

Treatment depends on the Pap smear result. Most abnormal results do not mean you have cancer. If abnormal cells are found, your provider may recommend a colposcopy (a closer look at the cervix) or a biopsy (a small tissue sample). If precancerous changes are confirmed, treatments can remove the abnormal cells and prevent cancer from developing.

Self-care at home

• Attend all recommended screenings and follow-ups.
• If you smoke, consider quitting — smoking increases the risk of abnormal cells developing into cancer.
• Use condoms to lower the risk of HPV and other sexually transmitted infections.

Medical treatments

If a biopsy reveals high-risk cell changes, common approaches include: removing the abnormal area using a thin wire loop (loop electrosurgical excision procedure or LEEP), freezing the abnormal cells (cryotherapy), or using a laser. These are usually done in an outpatient setting and are very effective at preventing cervical cancer.

When is surgery considered?

In rare cases, such as early-stage cervical cancer, surgery may be needed. This could include removing the cone-shaped piece of tissue containing abnormal cells (cone biopsy) or, in more advanced cases, a hysterectomy (removal of the womb and cervix). Your healthcare team will discuss the best options for your situation.

Living with this condition

After a Pap smear, you can return to normal activities immediately. If you have an abnormal result, you may need to see your provider more often for monitoring. Most people live normal, healthy lives with routine screening.

Lifestyle tips

• Keep up with your recommended screening schedule.
• Practice safe sex to reduce the risk of HPV.
• If you have had treatment, follow your provider’s advice about sexual activity and recovery.

Diet and exercise

A balanced diet, regular exercise, and not smoking support a healthy immune system, which can help clear HPV infections. There is no specific diet needed for Pap smear screening.

Mental health and emotional wellbeing

Waiting for results or getting an abnormal result can cause anxiety. Remember that most abnormal results are not cancer, and follow-up tests are common. Talking to your healthcare provider or a trusted support person can help.

Prevention

Cervical cancer is highly preventable with regular Pap smears, which catch abnormal cells early. You can also lower your risk by getting the HPV vaccine, avoiding smoking, and using condoms.

Vaccines

The HPV vaccine is recommended for preteens and young adults to prevent infection with the types of HPV that most commonly cause cervical cancer. It works best when given before any exposure to the virus.

Screening programmes

Regular Pap smears (and HPV testing) as recommended by your national health guidelines are the best way to prevent cervical cancer.

Complications

If left untreated

• If abnormal cells on the cervix are not found and treated, they can develop into cervical cancer over time (usually many years).
• Cervical cancer can spread to nearby tissues and other parts of the body, making treatment more difficult.

Long-term outlook

With regular screening, cervical cancer is one of the most preventable and treatable cancers. The vast majority of people who have timely follow-up for abnormal Pap smears are successfully treated and do not develop cancer. Even when cancer is found early, the chances of cure are very high.

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