The Bottom Line With PAP Smears

July 16, 2023
Lisa P. Otey, MD


Pap smears, or Pap tests, is a laboratory examination that inspects the cells of the cervix. It is highly effective in detecting abnormalities in cell structure, abnormalities that may herald the development of cancer. Most women, especially sexually active ones, will benefit greatly from regular pap tests. A Houston Gynecologist can get a PAP smear done in the office in a matter of minutes.

What is a Pap smear?

The cervix is the opening to the uterus that is located on top of the vagina. Like skin, the cervix is made up of several layers of cells. The youngest cells are found at the base or the bottom. As these cells grow and develop, they gradually push the more superficial cells towards the surface. As this happens, there might be possibly some abnormalities or damage that may occur. These abnormalities may be harmless, but in some cases, they might lead to cancer. If they have developed into precancerous cells, they are said to have undergone dysplasia. This can either be graded as mild, moderate, or severe. A Houston Gynecologist will review the implications of an abnormal PAP smear in great detail and offer up-to-date solutions.

In a Pap smear or Pap test, a vaginal speculum is used to open the vagina. This is done so that the doctor can have a clear view of the cervix. A small brush is then used to swab the cervix. In doing this, a small sample of cells is obtained. This sample is either immersed in a solution or sent to the lab for examination, or they can be directly put on a glass slide and then sent to the lab. This sample is examined under a microscope.

Pap smears can detect abnormal cervical cells that may or may not signal cancer. For women infected with human papilloma virus (HPV), their cervical cells appear abnormal under a microscope. HPV is the leading cause of cervical cancer. In most women, their immune system is strong enough to fight the virus, and the abnormal appearance of the cells normalizes over time. In some women, however, HPV persists, causing the cells to develop cancer.

Who Should Have Pap Smears?

Ideally, Pap smears are done starting at 21 years. Women should have Pap smears done regularly, so that cancer or precancerous changes can be detected as early as possible. Early diagnosis makes treatment easier, and correspondingly, ensures a higher degree of success.

How Often Should I Have a Pap Smear?

It all depends on your current age and your health history. Ideally, women under 30 years of age should have a Pap smear done at every 3 years. For women over 30, having a Pap smear every 2 years is recommended. If you are over 30 and have had 3 normal Pap smears in a row, you may have it done every 3 years if you meet the following criteria:

  • You haven’t had a result of moderate or severe dysplasia ever
  • You aren’t infected with human immunodeficiency virus (HIV)
  • You aren’t immunocompromised, or in other words, your immune system isn’t weakened by medications, recent organ transplant, or other causes
  • Your mother hasn’t taken diethylstilbestrol (DES) when she was pregnant with you

Several years ago, Pap smears were recommended to be done annually, but recent research studies have shown that cervical cancer risk remains the same whether you have Pap smears done every year or every 2 years. Additionally, for women over 30 years of age who have had three normal Pap smear results, it has been found that their risk of severe dysplasia to occur is low. As a result, Pap smears every 3 years have become the standard. However, this doesn’t mean that you visit your gynecologist every 3 years. Having annual check-ups is still important for well-woman care.

When Should I Stop Having Pap Smears?

Actually, there is no standard rule as to when women can stop having Pap smears. Most experts claim that it’s safe to stop having Pap smears if you are already above 65 to 70 years of age and if you have had 3 normal results consecutively within the past 10 years. If you have certain risk factors, such as being sexually active or having a history of multiple sexual partners, or have had abnormal Pap smear results in the past, your physician may recommend you to continue having Pap smears done.

I Have Abnormal Results. Now What?

Actually, having abnormal Pap smear results is pretty common. Keep in mind, however, that abnormal isn’t the same as cancer. In most cases, cells with mild abnormalities resolve by themselves.

Most likely, your physician will advise you to undergo additional testing, may it be a repeat Pap smear, an HPV test, or a colposcopy. If these tests reveal precancerous changes, then you may need to undergo treatment. You can talk about your options with your doctor.

Contact us by phone or web to make a same day appointment to discuss your specific needs. We’re always happy to hear from you!