Pap Tests

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 detect infections or to detect cancer of the ovaries or uterus.

Who Needs A Pap Test?

All women who have ever had sexual intercourse are advised to start having Pap tests two years after they started having sex or at the age of 18: whichever is LATER. Most women can stop having Pap tests at the age of 70.

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 should not be 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 additional test is not covered by Medicare and there will be an extra cost for any woman who has them done.

You will be asked if you are happy for your name to go on the Pap test register. This ensures that you get a reminder if you miss your next test, and means that your results will be available in the future to the doctor and the laboratory which carried out the test.

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.

A small number of 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 Family Planning clinic (usually no out-of-pocket cost with a Medicare card for taking the test)
• a Women's Health Clinic (usually no cost 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 a low grade abnormalities means that minor changes were found. These changes are caused mostly by an infection called the Human Papilloma Virus (HPV). HPV is a very common 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 by about one year. 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 on the Pap test result suggests that HPV infection has persisted and the doctor will need to refer you for further investigations to a specialist gynaecologist.
• 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. This is why it is important to have regular tests every 2 years.

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, regular screening can prevent most cases of cervical cancer.

HPV Vaccination

An additional important way to reduce the chance of developing cervical cancer is the HPV vaccination. There is a government funded vaccine program for high school aged girls. Older women can discuss this with their doctor, Family Planning clinic doctor or nurse, or ring our Family Planning NSW Healthline.

It is important for women to continue to have Pap tests even if they have had the vaccine.

You may like to refer to our HPV vaccination factsheet for more information.

For Further Information

Contact Family Planning NSW Healthline on 1300 658 886
Or email: healthline@fpnsw.org.au
NRS (for deaf) 133 677
Or visit your nearest Family Planning clinic

The information in this Factsheet has been provided for educational purposes only. FPNSW has taken every care to ensure that the information is accurate and up-to-date at the time of publication. Individuals concerned about any personal reproductive or sexual health issue are encouraged to seek advice and assistance from their health care provider or visit a Family Planning clinic.

Reviewed: March 2012   |   FPNSW 03/12