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Pap test

The Pap test (or Pap smear) looks for cancers and precancers in the cervix (the lower part of the uterus that opens into the vagina). Precancers are cell changes that might become cancer if they are not treated the right way. Most health insurance plans must cover Pap tests or cervical cancer screening at no cost to you.

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What is a Pap test?

A Pap test checks the cervix for abnormal cell changes. The cervix is the lower part of the uterus (womb), which opens into the vagina. Cell changes can develop on the cervix that, if not found and treated, can lead to cervical cancer. Cervical cancer can almost always be prevented, and having regular Pap tests is the key.

Why do I need a Pap test?

A Pap test can save your life. It can find early signs of cervical cancer. If caught early, the chance of successful treatment of cervical cancer is very high. Pap tests can also find abnormal cervical cells before they turn into cancer cells. Treating these abnormal cells can help prevent most cases of cervical cancer from developing. Getting a Pap test is the best thing you can do to prevent cervical cancer.

Do all women need Pap tests?

Most women ages 21 to 65 should get Pap tests as part of routine health care. Even if you are not currently sexually active, you should still have a Pap test. Women who have gone through menopause (when a woman’s periods stop) and are younger than 65 still need regular Pap tests.

Women who do not have a cervix (usually because of a hysterectomy), and who also do not have a history of cervical cancer or abnormal Pap results, do not need Pap tests. Women ages 65 and older who have had three normal Pap tests in a row and no abnormal test results in the last 10 years do not need Pap tests.

Who does not need a regular Pap test?

The only women who do not need regular Pap tests are:

  • Women ages 65 and older who have had three normal Pap tests in a row and no abnormal test results in the last 10 years, and have been told by their doctors that they don’t need to be tested anymore.
  • Women who do not have a cervix (usually because of a hysterectomy) and who do not have a history of cervical cancer or abnormal Pap results.

All women should speak to a doctor before stopping regular Pap tests.

I had a hysterectomy. Do I still need Pap tests?

It depends on the type of hysterectomy (surgery to remove the uterus) you had and your health history. Women who have had a hysterectomy should talk with their doctor about whether they need routine Pap tests.

  • If you no longer have a cervix because you had a hysterectomy for reasons other than cancer, you do not need Pap tests.
  • If you had a hysterectomy because of abnormal cervical cells or cervical cancer, you should have a yearly Pap test until you have three normal tests.
  • If you had your uterus removed but you still have a cervix (this type of hysterectomy is not common), you need regular Pap tests until you are 65 and have had three normal Pap tests in a row with no abnormal results in the last 10 years.

How often do I need to get a Pap test?

It depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:

  • If you are between ages 21 and 29, you should get a Pap test every 3 years.
  • If you are between ages 30 and 64, you should get a Pap test and human papillomavirus (HPV) test together every 5 years or a Pap test alone every 3 years.
  • If you are 65 or older, ask your doctor if you can stop having Pap tests.

Some women may need more frequent Pap tests. You should talk to your doctor about getting a Pap test more often if:

  • You have a weakened immune system because of organ transplant, chemotherapy, or steroid use.
  • Your mother was exposed to diethylstilbestrol (DES) while pregnant.
  • You have had treatment for abnormal Pap results or cervical cancer in the past.
  • You are HIV-positive. Women who are living with HIV, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S. Centers for Disease Control and Prevention (CDC) recommends that all HIV-positive women get an initial Pap test, and get re-tested 6 months later. If both Pap tests are normal, HIV-positive women can get yearly Pap tests in the future.

How can I prepare for a Pap test?

Some things can cause incorrect Pap test results.

For two days before the test do not:

  • Use tampons
  • Use vaginal creams, suppositories, or medicines
  • Use vaginal deodorant sprays or powders
  • Have sex
  • Douche

Should I get a Pap test when I have my period?

No. Doctors suggest you schedule a Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your period.

How is a Pap test done?

Your doctor can do a Pap test during a pelvic exam. It is a simple and quick test. You will lie down on an exam table. Your doctor will put an instrument called a speculum into your vagina and will open it to see your cervix. He or she will then use a special stick or brush to take a few cells from the surface of and inside the cervix. The cells are placed on a glass slide and sent to a lab for testing. A Pap test may be mildly uncomfortable but should not be painful. You may have some spotting afterwards.

When will I get the results of my Pap test?

Usually it takes one to three weeks to get Pap test results. Most of the time, test results are normal. If the test shows that something might be wrong, your doctor will contact you to schedule more tests. There are many reasons for abnormal Pap test results. Abnormal Pap test results do not always mean you have cancer.

My Pap test was “abnormal.” What happens now?

It can be scary to hear that your Pap test results are “abnormal.” But abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix. If results of the Pap test are unclear or show a small change in the cells of the cervix, your doctor may repeat the Pap test immediately, in 6 months, or a year, or he or she may run more tests.

Some abnormal cells will turn into cancer. Treating abnormal cells that don’t go away on their own can prevent almost all cases of cervical cancer. If you have abnormal results, talk with your doctor about what they mean. Your doctor should answer any questions you have and explain anything you don’t understand. Treatment for abnormal cells is often done in a doctor’s office during a routine appointment.

If the test finds more serious changes in the cells of the cervix, the doctor will suggest more tests. Results of these tests will help your doctor decide on the best treatment.

My Pap test result was a “false positive.” What does this mean?

Pap tests are not always perfect. False positive and false negative results can happen. This can be upsetting and confusing.

  • False positive. A false positive Pap test occurs when a woman is told she has abnormal cervical cells, but the cells are not actually abnormal or cancerous. If your doctor says your Pap results were a false positive, there is no problem.
  • False negative. A false negative Pap test is when a woman is told her cells are normal, but there is a problem with the cervical cells that was missed. False negatives delay the discovery and treatment of unhealthy cells of the cervix. But having regular Pap tests boosts your chances of finding any problems. Cervical cancers usually take many years to develop. If abnormal cells are missed at one time, they will probably be found on your next Pap test.

How can I reduce my chances of getting cervical cancer?

You can reduce your chances of getting cervical cancer in several ways:

  • Get regular Pap tests. Regular Pap tests help your doctor find and treat any abnormal cells before they turn into cancer.
  • Get an HPV vaccine (if you are 26 or younger). Most cases of cervical cancer are caused by a type of HPV that is passed from per­son to person through genital contact. Most women never know they have HPV. It usually stays hidden. While it sometimes goes away on its own, it can cause changes in the cells of the cervix. Pap tests usually find these changes. To learn more, read this fact sheet on HPV vaccines and young women.
  • Be monogamous. Having sex with just one partner can also lower your risk. Be faithful to each other. That means that you only have sex with each other and no one else.
  • Use condoms. The best way to prevent any sexually transmitted infection (STI), including HPV, the cause of most cases of cervical cancer, is to not have vaginal, oral, or anal sex. If you do have sex, use condoms. Condoms lower your risk of getting HPV and other STIs. Although HPV can also occur in female and male genital areas that are not protected by condoms, research shows that condom use is linked to lower cervical cancer rates. Protect yourself with a condom every time you have vaginal, anal, or oral sex.

How can I get a free or low-cost Pap test?

Pap tests are covered under the Affordable Care Act, the health care law passed in 2010. Most insurance plans now cover Pap tests at no cost to you.

For information about other services covered by the Affordable Care Act, visit HealthCare.gov.

For more information…

For more information on Pap tests, call the OWH Helpline at 800-994-9662 or contact the following organizations:

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All material contained in this fact sheet is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the Department of Health and Human Services. Citation of the source is appreciated.

Pap test fact sheet was reviewed by:

Pamela Marcus, PhD, Epidemiologist National Cancer Institute, Division of Cancer Control and Population Sciences

Paul Doria-Rose, PhD, DVM, Epidemiologist National Cancer Institute, Division of Cancer Control and Population Sciences

Content last updated: October 23, 2013.

Content last reviewed: January 03, 2014.

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