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Cervical Screening Frequently Asked Questions

Cervical cancer can be prevented by finding cell changes in the cervix and treating them, if necessary. Screening is the only way to detect these early cell changes.

About Pap Tests

What is a Pap test?

A Pap test is a simple screening test that can help prevent cancer of the cervix (cervical cancer). A Pap test looks for abnormal cell changes in the cervix. It does not test for other cancers in the reproductive organs or for sexually transmitted infections, such as chlamydia, gonorrhea or HIV.

A Pap test is done in a healthcare provider’s office, either by a doctor or nurse practitioner. Some women may find it uncomfortable or embarrassing, but it takes only a few minutes. To do a Pap test, you will be asked to lie on your back on an examining table. An instrument, called a speculum, is gently inserted in your vagina so your cervix can be more clearly seen. Cells are taken from the cervix and are sent to a laboratory to be examined under a microscope.

 

Why are Pap tests needed?

A Pap test looks for abnormal cells in the cervix. Sometimes cervical cells become abnormal over time as they die and then renew. They are also abnormal when a woman has a human papillomavirus (HPV) infection. Abnormal cells often return to normal on their own. But if they do not, they need to be found and, if necessary, treated. Otherwise, slowly over a number of years, they may become cervical cancer.

Should you have a Pap test?

  • If you have ever had any sexual skin-to-skin contact, you need to have regular Pap tests starting at age 21. This includes intercourse, intimate touching or oral sexual contact.
  • Pap tests should be a part of your regular healthcare until you are 70 years old. The risk of getting cancer of the cervix does not decrease with age.
  • Pap tests can stop at the age of 70 if you have had 3 or more normal tests in the previous 10 years.
  • If you have had a hysterectomy, talk to your doctor to see if you still need a Pap test.

Pap Test Questionnaire

Ask yourself the following questions to help determine whether you need a Pap test.

If... DO I NEED A PAP TEST?
I feel healthy and have no symptoms
I have never had intimate sexual contact
I am no longer sexually active
I have had only 1 sexual partner
I am in a same sex relationship
I have been through menopause
I have no family history of cervical cancer
I am under 21

 

How often should you have a Pap test?

You should have a Pap test every 3 years. If you develop abnormal cells, your cervical screening plan will change.

Are Pap tests effective?

Yes, but they are not perfect. They can miss some abnormal cells. Be sure that you are going for regular Pap test screening. Regular screening decreases the chance of missing important changes. If you have unusual vaginal bleeding or discharge, see your doctor, even if your last Pap test was normal.

Where do I go for a Pap test?

Make an appointment with your doctor. If you do not have a doctor, you can register for Health Care Connect at 1-800-445-1822 or visit the Health Care Connect website.

Some public health units and community health centres also provide Pap tests. For information on healthcare services in your community, visit Health Care Options. Women in the North West and Hamilton Niagara Haldimand Brant regions may be eligible for cervical screening in one of our mobile screening coaches.

How do I get ready for a Pap test?

  • Try to make the appointment for a day when you do not have your period.

  • Don’t have sex or use tampons, creams or medicines in your vagina for 48 hours before the test.

  • If the earlier points can’t be avoided, still go for your test.

Test Results and Follow-Up

What happens after a Pap test?

Your doctor will contact you if you have an abnormal test result. The Ontario Cervical Screening Program will also send you a letter telling you whether your test result is normal, abnormal or unsatisfactory, and provide you with next steps. If you do not wish to receive letters from the Ontario Cervical Screening Program, please call 1-866-662-9233.

Most often, your Pap test result will be normal. If your result is abnormal, it does not mean you have cervical cancer. But you will need to talk to your doctor about next steps, such as a repeat Pap test in a few months. If needed, you may also have to see a specialist for more tests.

What is an abnormal Pap test result?

An abnormal Pap test result means that the cells taken from your cervix look different under the microscope than normal cells. Cell changes found through Pap tests are very rarely cancer, but do require follow-up testing. Cancer of the cervix may take a long time to develop, and there are usually no early warning signs or symptoms. Fortunately, regular Pap testing can find most abnormal cells in the cervix before they turn into cancer.

What causes an abnormal result?

Usually changes in the cells of the cervix are caused by the human papillomavirus (HPV):

  • HPV is a family of viruses commonly found in men and women.
  • Most people come into contact with HPV through sexual contact at some point in their lifetime. Usually there are no symptoms and often people do not know that they had an HPV infection.
  • Usually the infection goes away naturally within about 1 to 2 years.
  • Sometimes, for reasons that are not well understood, an HPV infection does not go away. Instead, it stays in the body for a long time. Over a number of years, the infection may slowly lead to cancer if the abnormal cells are not found and, if necessary, treated.

    Why is follow-up so important?

    Follow-up of abnormal Pap test results is important because it can help prevent cervical cancer. Abnormal cells often change back to normal naturally. However, in some women, the abnormal cells do not change back to normal and cancer can develop. It’s important to do follow-up tests of these abnormal cells, and treat them if necessary, to prevent cervical cancer from developing.

    What happens after an abnormal Pap test?

    Talk to your doctor about your result and the follow-up testing needed. Your follow-up plan depends on your type of cell changes:

    • You may be asked to repeat your Pap test more often for a short period of time, for example every 6 months. This allows time to see if the abnormal cells change back to normal on their own.
    • Your doctor may suggest a human papillomavirus (HPV) test.
    • You may be referred for a special examination called colposcopy.

      What is colposcopy?

      Colposcopy is an exam that is similar to a Pap test. It is done by a healthcare provider with special training in this area.

      The exam allows the specialist to look more closely at your cervix with a magnifying lens (colposcope) to see your cervix in more detail. You will be asked to lie on your back and, as with a Pap test, an instrument called a speculum will be gently inserted into your vagina to allow the cervix to be clearly seen. A liquid will be applied to the cervix to help highlight any abnormal areas.

      If any area of concern is found, the specialist will take a small sample of tissue from your cervix (biopsy) for a closer look under a microscope in a lab. The biopsy can help determine whether treatment is needed or not.

      What happens after colposcopy?

      To make sure the cells return to normal you may need a follow-up Pap test or another colposcopy. You may possibly need treatment. There are many simple ways to successfully treat the source of the abnormal cells.

      What else can you do after receiving an abnormal result?

      Follow-up testing is the most important thing you can do. However, your body will be better able to fight off a human papillomavirus (HPV) infection if you are strong and healthy. One thing that can help you stay healthy is to be tobacco free and avoid second-hand smoke.

      Important Points to Remember

      • Going for regular Pap tests is important for staying healthy. An abnormal Pap test result can be stressful. However, keep in mind that the reason for going for regular Pap tests is to find early changes in the cervix, when treatment is simpler and more likely to be successful.
      • Following up on abnormal Pap test results can most often prevent cervical cancer from developing.
      • Seeing your doctor on a regular basis allows for frequent health checkups. If you have questions about your clinical care, please speak to your doctor.