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Factsheet

Pap Tests

Date 28 February 2008

The Pap test is an easy way to detect early changes in the cells of the cervix (the lower end of the womb or uterus). Without treatment, these changes could lead to cancer. If you have regular Pap tests, these cell changes can be detected and treated early. This reduces the chance of cancer developing. Quite simply, regular Pap tests could save your life. Pap tests are not designed to pick up infections or to detect cancer of the ovaries or uterus.

WHO NEEDS A PAP TEST?

Every woman, whatever her age, should have regular Pap tests if she has ever had sexual intercourse. For your own peace of mind and good health, begin having regular Pap tests approximately two years after you start having sexual intercourse.

HOW IS A PAP TEST DONE?

The doctor or nurse will give you an internal (vaginal) examination. A small instrument called a speculum is inserted into your vagina. This holds the walls of the vagina apart. Cells are gently wiped with a soft brush from around the tiny opening in the cervix. This usually takes no more than five minutes. It may be a little uncomfortable but it is not painful.

WHAT HAPPENS THEN?

The cells taken from the cervix are placed on a glass slide that is sent off to the laboratory to be examined under a microscope. Sometimes the doctor or nurse will suggest an extra test where the cells are not only placed on the slide but also preserved in fluid. This extra test might be recommended when there is inflammation or bleeding from the cervix at the time of the Pap test, or when you have had abnormal Pap tests in the past. It is also recommended if the pathologist found your previous Pap tests difficult to read.

These additional tests are not covered under Medicare and there will be an extra cost for any woman who has them done. Check how long it will take to get the results back, and be sure to ask how your health provider will notify you of the results of the Pap test.

About one in ten Pap tests will show a problem that needs following up. Most of these problems are minor and are not cancer - so don't think the worst if you're asked to come back to discuss your Pap test result. Your doctor will tell you if any further tests or treatment is needed and will arrange this for you. Remember: the earlier a change is found the easier it is to treat.

HOW OFTEN SHOULD I HAVE A PAP TEST?

Because new cells in the cervix regularly replace old cells, and because a Pap test is not 100% accurate, it is strongly suggested that you have a Pap test every two years until you are 70 years old. Your doctor or nurse may suggest more frequent Pap tests if you have had problems in the past. Regular tests are the best way to find changes that warn of cancer. If you have any unexpected bleeding or increased discharge from your vagina, it is important that you see a doctor as soon as you can, even if you have recently had a normal Pap test. Having regular Pap tests is an important step in staying healthy.

WHERE DO I GO TO HAVE A PAP TEST?

You can go to:

any doctor (there may be a fee, so ask about this)
a Women's Health Clinic (usually no cost for taking the test)
A Family Planning NSW clinic or another Family Planning Clinic (usually no additional cost with a Medicare card, for taking the test).

WHAT DO THE RESULTS MEAN?

A negative report (usually described as 'normal') means that no significant changes were seen in the cells.
A report of low grade abnormalities means that minor changes were found. These changes are caused mostly by a viral infection called HPV. This is a very common sexually transmitted virus. Most sexually active people will have this infection at some time in their lives and they may not even know about it. This is not cancer. Most of these infections will be cleared by the body in one to two years. A Pap test will be repeated in 12 months to make sure that the cells in the cervix have returned to normal.
A report of a high grade abnormality on the Pap test means that there are changes that your doctor will need to investigate further.
A report of possible high-grade abnormality changes on the Pap test result suggests that HPV infection has persisted and the doctor will need to refer you for further investigations.
An unsatisfactory test occurs when the cells are hard to see because blood or vaginal bacteria are present, or the sample of cells is too small. There are a number of reasons why this may happen. These are often out of the control of the person who took the test or the laboratory that examined it. A further Pap test will be recommended.
HOW ACCURATE IS IT?
Like all screening tests, the Pap test is not 100% accurate for a number of reasons. For example the test may not always pick up abnormal cells that are present on only one small part of the cervix. Some tests can be hard to interpret or there may be abnormal cells on the Pap test slide, which are not seen by the pathologist at the time of screening. However, early screening can prevent most cases of cervical cancer. Information reproduced (with minor modifications) with permission from NSW Cancer Council and Victorian Cytology Service Inc.

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