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Demystifying the Pap Smear

April 29, 2024

Doctor speaking with patient sitting on exam table

Most women know what a mammogram is — and get their regular screenings. But this isn’t necessarily the case for pap smears. Miriam Aioub, MD, an obstetrician/gynecologist at Atlantic Health System, explains why this cervical cancer screening for women is so important.

“Just as a mammogram is an excellent screening tool to detect breast cancer, a pap smear is an excellent way to screen for cervical cancer — and more,” she says. “It allows us to detect pre-cancerous abnormalities of the cervix, and human papilloma virus, or HPV, which causes most cases of cervical cancer.”

How Do Pelvic Exams and Pap Tests Differ?

Pelvic exams and pap smears are not the same. A speculum examination is a part of the pelvic examination. It is when a speculum device is inserted into the vagina to evaluate the vagina and cervix. A pap smear is when your doctor collects cells from the cervix using a brush and a spatula and sends them to the lab for evaluation. Although this can be done by a primary care doctor, it is commonly performed by a gynecologist as part of a complete well woman exam.

Who Should Get a Pap Smear, and When?

The American College of Obstetricians and Gynecologists (ACOG) recommends a woman’s first pap smear at age 21. Women ages 21 to 29 should be tested every three years. Women ages 30 to 65 should be tested every three to five years, depending on the type of pap smear collected. By age 65, women no longer need to be screened for cervical cancer if they have been receiving their routine pap smears and they have all been normal.

“This does not mean that you can skip your yearly checkup with your gynecologist. There are other important parts of the yearly visit in addition to pap smears,” says Dr. Aioub. “Though pap smear screening begins at age 21, it is a good idea for younger patients to visit a gynecologist earlier, especially if they’re considering sexual activity. We help guide adolescents and teenagers through contraception, growth and development, and questions they have about their bodies.”

Why Are Pap Tests Overlooked?

Dr. Aioub explains that after some patients have babies, they may not come back for follow-up gynecologic care for 20+ years. That’s too long because, for some, when they return later in life, they are diagnosed with late-stage cervical cancer that could have been prevented.

“Even if you are sexually active with one partner, it is important to come back and see your gynecologist because pap smears still help to prevent cervical cancer,” says Dr. Aioub. “They can occasionally even catch uterine cancer, too. And remember, the annual gynecologic visit is for much more than the pap smear alone.”

Stay on Schedule With Your Pap Test

“When women come in for pregnancy care, I like to make sure they’re up-to-date with routine screenings — and that always includes a pap test,” says Dr. Aioub. “My recommendation is to continue to see a gynecologist throughout your adult life, even after menopause. At your visits, we look for any abnormalities including an enlarged uterus or ovaries, ovarian cysts, or abnormal cells and pathologies that could be benign or lead to malignancies.”

Screenings Keep Cancer Cases Low

With excellent screening tools available that detect cervical cancer and precancer lesions early, women can avoid disease progression to cervical cancer. Treatment can often be provided right in your gynecologist’s office or operating room and involves removing the abnormal cells before they spread deeper into the cervix.

“When women get their scheduled pap smear and pelvic exams, we can detect and treat cervical cancer and HPV at the earliest stages,” says Dr. Aioub. “But we can only detect it if we’re screening for it. We have better options when we catch cervical cancer or HPV early. When we don’t, and it occurs in young women, it can have devastating effects.”

Be Proactive About Your Health

To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.

  • Women's Health