Currently, the most reliable method of finding cervical cancer early is the Pap test. A Pap test is a procedure that gently removes a small sample of cells from the cervix so they can be examined for changes. A Pap test is the main tool used to screen for cervical cancer because it can detect changes early, before cancer develops.
Here is some information to help you be prepared for your Pap.
Who needs to get screened?
What is a Pap test?
What happens during a Pap test?
Does it hurt?
How do I prepare for the test?
How can I make a Pap test more comfortable physically and emotionally?
How do I book a Pap test?
How will I get the test results?
If you are between 21 – 69 years old, have a cervix, and are or have ever been sexually active, get a Pap test every three years.
If you’re over 69, talk to your doctor about whether or not it’s appropriate to continue having Pap tests. The decision to stop is often based on having two or three normal Pap tests over the last ten years.
Get screened even if you:
If you have received abnormal test results in the past, you may need to get screened more frequently. Your health care provider will let you know.
Check out frequently asked questions for more information on who needs to get screened.
A Pap test, also known as a Pap smear, is the screening test that examines cervical cells to check for abnormal changes. Abnormal cells can, over time, change and become cancerous, often without any symptoms at all. If abnormalities are found early and monitored, they are usually easily treatable. Regular Pap tests are the most effective way to protect yourself from cervical cancer.
The Pap test is very quick, and often accompanied by a pelvic exam. The test allows a health care provider to look at the cells of the cervix as well as collect a sample to test for any cell changes.
The Pap test generally involves three instruments: a speculum, a brush and a spatula.
The Pap test usually takes 2 – 3 minutes.
Your healthcare provider will ask you about your health history, including your sexual health history. Your healthcare provider will likely ask you the date of your last period (the day it started), whether or not you are sexually active, if you’re using birth control, if you’re having any problems with your period such as pain or spotting, if there’s a possibility you might be pregnant, and other questions related to your sexual and reproductive health. You may also be asked about your sexual orientation or gender identity. This is a great time to discuss any specific needs you may have about how to make the Pap test more comfortable for you. If the healthcare provider is male, you may request a female staff person to sit in on the session or request a female health care provider.
Procedures may vary from place to place but generally you will be asked to remove your clothes from the waist down and be provided with a paper gown or sheet. The healthcare provider will leave the room or draw a curtain so that you can get changed in privacy. You will be asked to lie down on an examination table, with your bottom to the very edge of the table. They may ask you to place your feet in stirrups to help your healthcare provider ensure a good view of the cervix.
Using gloved hands, your healthcare provider will gently insert a small instrument, called a speculum, into your vagina. Once inserted, the speculum gently pushes apart the walls of the vagina so that the upper part of the vagina and cervix are directly viewable by the healthcare provider. The healthcare provider will then use the wooden spatula to gently scrape cells from the outside of the cervix, and then use a brush to scrape cells from the inside of the cervix. The cells get put into a vial of liquid, and are sent to the lab for analysis.
Sometimes people experience discomfort, pressure or cramping during the procedure and you may also experience vaginal bleeding for 1-2 days after a Pap test.
A Pap test can be uncomfortable, but usually doesn’t hurt. The cervix does not have a lot of nerve endings, which means that there are fewer receptors available to feel sensation, so pain is less likely. It may be uncomfortable or painful to have a speculum inserted into your vagina, but it can help to take deep breaths to relax your pelvic floor muscles and ease tension. If you are experiencing pain during your test, let your healthcare provider know.
Before you book your Pap test, here are some things to think about:
In Ontario, you can get a Pap test from your family doctor, a gynecologist, a nurse or nurse practitioner. You can also get one at most sexual health clinics. You can get information on finding a health care provider who is also knowledgeable about lesbian, gay, bisexual, transgender and queer health care by visiting the Rainbow Health Ontario provider directory.
Ask your healthcare provider when you can expect to get your results. Generally, you will only be contacted if your test results are abnormal. If you don’t hear from your healthcare provider, it’s likely because your results are normal.
You may feel anxious or nervous about receiving your test results. Remember, cervical cancer is rare. There are many reasons why someone might have an abnormal Pap test, and most often, it isn’t cancer.
If your test results are negative, this means that your cervical cells are normal and that you can come back in three years to get another Pap test.
If your test results are positive, this means that some of your cervical cells are abnormal, and that you will likely need further testing. While this may sound scary, further testing will help your provider find out more information about the cervical cell changes.