Patient Basics: Pap Test (Papanicolaou Smear)

A Pap test, short for Papanicolaou test and also called a Pap smear, gently wipes a few cells off the cervix, the narrow lower end of the uterus, to look for changes that could turn into cancer. It takes a minute or two during a pelvic exam. Regular screening with a Pap test, an HPV test or both finds problems early, when they are easy to treat, and has made cervical cancer far less common.

Key points

• Most people with a cervix should start screening at age 21.
• From 30 to 65, an HPV test every 5 years is a preferred option. A Pap test alone every 3 years is also fine.
• The test may feel uncomfortable for a moment, but it shouldn’t hurt.
• Most abnormal results are not cancer. They often come from an HPV infection that clears on its own.
• People who have had the HPV vaccine still need screening.

Why a Papanicolaou test is done

Almost all cervical cancers are caused by long-lasting infection with high-risk types of human papillomavirus (HPV), a very common virus spread by sexual contact. Most HPV infections go away within a year or two. When one doesn’t, it can slowly change the cells of the cervix over many years. A Pap test spots those changed cells. An HPV test looks for the virus itself. Both can be done from the same sample.

Who needs it and how often

These are the usual schedules for people at average risk. Your doctor may suggest a different plan.

• Ages 21 to 29: a Pap test every 3 years. Some guidelines now start HPV testing at 25.
• Ages 30 to 65: an HPV test every 5 years, a Pap and HPV test together (co-testing) every 5 years, or a Pap test alone every 3 years.
• Over 65: most people can stop if past results were normal for 10 years and there’s no history of serious cell changes.
• After a hysterectomy: if the cervix was removed and the surgery wasn’t for cancer or precancer, screening usually isn’t needed.

You may need tests more often if you have HIV, a weak immune system, an organ transplant, past treatment for precancer, or were exposed before birth to a drug called DES. Screening applies to anyone with a cervix, including transgender men and nonbinary people who have one.

Some clinics now offer an HPV test you collect yourself with a soft swab, and at-home kits are becoming available. Ask whether this is an option for you.

Before the test

• Try to schedule it for a day when you don’t have your period. Light spotting is usually fine.
• For 2 days before, avoid douching, vaginal creams or medicines, and sex, as these can affect the sample.
• Tell your clinician if you are pregnant, have had abnormal results before, or have pain with exams.
• If exams make you anxious, you can ask for a smaller speculum, bring a support person, or ask for a chaperone to be present.

During the test

You undress from the waist down and lie face up on an exam table, usually with your feet resting in supports. The clinician gently inserts a speculum, a smooth tool that holds the vaginal walls apart so the cervix can be seen. They then use a small soft brush and a thin spatula to wipe cells from the cervix. The cells go into a small bottle of liquid that is sent to a lab.

You may feel pressure or a brief cramp. Slow, deep breaths and relaxing your thigh and belly muscles help. Tell the clinician if anything hurts, and they can stop or adjust.

A Pap test is often done during a pelvic exam, where the clinician also feels the uterus and ovaries. The two are not the same, and you can have one without the other.

Afterward

You can go back to your normal activities right away. A little spotting or mild cramping for a day is common. The test carries almost no risk.

Your results

Results usually come back within 1 to 3 weeks. If you haven’t heard, call the office. No news doesn’t always mean normal.

• Normal (negative). No changed cells were seen. You can wait until your next routine test.
• Unclear (ASC-US). Some cells look slightly unusual. The lab often checks the same sample for HPV to decide the next step.
• Low-grade changes (LSIL). Mild changes, usually from HPV, which often clear on their own.
• High-grade changes (HSIL) or other abnormal results. More serious changes that need a closer look soon. These are still usually precancer, not cancer.
• Positive HPV test. A high-risk type of HPV was found. What happens next depends on the type and your Pap result.

If your results are abnormal

Next steps depend on the result and your past history. You may be asked to:

• Repeat the test in 1 year to see whether the changes have cleared
• Have a colposcopy. The clinician looks at the cervix through a magnifying scope and may take a tiny sample of tissue (biopsy).
• Have treatment to remove the abnormal area, most often with a thin electric wire loop (LEEP). This is done in the office and prevents cancer from developing.

Treatment for precancer is very effective. Keep every follow-up visit, since missed follow-up is a common reason cancer develops.

Lowering your risk of cervical cancer

• Get the HPV vaccine. It is recommended at ages 11 to 12 and can be given through age 26. Some adults up to 45 may benefit, so ask your doctor.
• Keep up with screening on schedule.
• Use condoms, which lower but don’t remove HPV risk.
• Don’t smoke. Smoking makes it harder for the body to clear HPV.

When to call your doctor

• You haven’t received your results after 3 weeks
• Heavy bleeding, fever or bad pain after the test
• Bleeding after sex, between periods or after menopause, even if your last test was normal
• Unusual discharge or pelvic pain

Common questions about the Papanicolaou test

Does a Pap test hurt?

Most people feel pressure or a brief pinch rather than pain, and the sampling is over in a minute or two. It can be more uncomfortable after menopause or if you’re tense. Tell your clinician, who can use a smaller speculum, more lubricant or simply go slower.

Does a Pap test check for STDs?

No. A Pap test looks for cell changes on the cervix, and an HPV test looks only for HPV. Tests for chlamydia, gonorrhea, HIV and syphilis are separate, so ask for them if you might be at risk. Some can be done at the same visit.

Can I have a Pap test while pregnant?

Yes. A Pap test is safe during pregnancy and is often done at the first prenatal visit if you’re due for one. Light spotting afterward is common. Abnormal results are usually checked with a colposcopy, and any treatment is often put off until after the birth.

Why is it called a Papanicolaou test?

It is named after Dr. George Papanicolaou, a Greek-American doctor who developed the test in New York between the 1920s and 1940s. In English it is usually shortened to Pap test or Pap smear. In Spanish it is often called el Papanicolaou or examen de Papanicolaou.

Questions to ask your doctor

• Which screening test are you doing today, Pap, HPV or both?
• When should my next test be?
• What does my result mean, and what are the next steps?
• Can I collect my own HPV sample?
• Should I get the HPV vaccine?

Learn more

• Pap smear (MedlinePlus, U.S. National Library of Medicine)
• Cervical cancer screening (National Cancer Institute)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.