When is a PAP Necessary?

A Papanicolaou (PAP) test is a screening tool for prevention of cancer. Cervical cancer occurs in the bottom part of the uterus in women. The main symptom is abnormal vaginal bleeding but very often in early stages there are no symptoms. For this reason, screening is important.

Papanicolaou smear (PAP) and the Human papillomavirus (HPV) test are the routine screenings for cervical cancer. These tests are performed by obtaining cells from the cervix using a small brush or spatula during a vaginal exam in the health providers office. It is a quick and painless exam.

The benefit to testing is early detection of cancer as it is generally curable in the early stages. The evidence of benefit is significant in women between the ages of 21 — 65 years old. Potential harms of screening are from false positive test results and over testing, but this is far outweighed by the significant benefits. These recommendations apply to women between age 21 — 65 that have not had a previous cervical cancer diagnosis and are not immune‐compromised.

Currently cervical cancer screening is recommended in women aged 21 — 65 years. For women 21–30, screening should be a PAP test every 3 years. For women 30–65 screening can be done by PAP every 3 years or by PAP test and HPV test every 5 years.

For women less than 21 years or older than 65 years the benefit of screening is unclear and needs to be individualized with your health care provider.

Dr. David Stahura, DO