Pap tests. No one ever looks forward to them. Many of us aren’t even sure what exactly they are for or why we need them. Below is some information on what the pap test is all about.
What is a Pap test?
- Your cervix is the narrow end of the uterus which has a small opening (called the os) that connects the uterus with the vagina.
- A Pap test is a microscopic examination of cells taken from the cervix done in a doctor’s office or health clinic. It is usually included as a part of an overall pelvic exam, which is a complete exam of the pelvic organs (uterus, ovaries, cervix, etc.).
- The Pap test is a screening tool for cervical cancer, which, through Pap tests and treatment where necessary, is preventable.
- The Pap test does not screen for any other forms of cancer.
- The Pap test is not a screening test for sexually transmitted infections (STIs). While the Pap test may show that cells of the cervix have been affected by HPV, an STI that can cause the cells of the cervix to become abnormal, it does not actually test specifically for HPV or any other STIs.
Why are Pap tests so important?
- If you have a Pap test regularly, you may be able to prevent cervical cancer by detecting and treating precancerous cervical changes.
- Cases of and deaths from cervical cancer have gone down by over 60% in the last 30 years, mostly due to screening using regular Pap tests (Cancer Care Ontario). Many who have cancer of the cervix have never had a Pap test. Having regular Pap tests and early treatment, if necessary, can prevent most cancers of the cervix.
- Research has shown that people who have a Pap test regularly are more likely to survive cervical cancer. If caught early, the chances of curing cervical cancer are very high.
While there has not been any research into rates of cervical cancer among trans men, we know that anyone with a cervix is at risk- and there are documented cases of cervical cancer in trans men.
How often should I get a Pap test?
- Pap tests should start within 3 years of your first sexual activity (oral, with fingers, sex toys, or a penis).
- Pap tests should be done every year, if possible.
- If you have never had an abnormal Pap test and have had 3 normal Pap tests in a row, you can start to do the test every 2-3 years.
- Once you hit 70 years of age, you may stop screening if you’ve had at least 3 consecutive normal Paps in last 10 years.
- You should have a regular pap regardless of who you have sex with: trans men who have sex with women should follow the same guidelines as those who have sex with men.
- If you are HIV-positive or have other immune system disorders, you should have a Pap test every year regardless of your pap test history.
- If you have had a total hysterectomy (in which your cervix was removed) for reasons not related to cervical abnormalities or HPV, after discussion with your health provider you may be able to discontinue cervical screening. (If you have had HPV or abnormal paps in the past, they may recommend that you have regular ‘vault’ or ‘cuff’ smears, at least until you have a few normal Pap results. If the results of previous Paps are unknown, they may recommend that you have at least one ‘vault’ smear.)
- If you’ve had a partial hysterectomy which left your cervix intact, you should continue screening according to the general guidelines.
- If you are pregnant, you should continue screening every year.
- You should continue with regular screening even if you have stopped having sex.
*Please note that these guidelines are based on the Ontario Cervical Screening Guidelines. Your province, state, or country may follow different guidelines for regular pap tests.*
How reliable is the Pap test?
- The Pap test is very reliable.
- You can make the test more reliable by having done when you are not bleeding and by avoiding the following if possible for 2 days before the test:
- Vaginal medications (unless advised by your doctor)
- Any kind of contraceptive such as spermicidal jelly, gels or foams
- ‘front hole’ intercourse with toys, dildos or penises for 24 hours before the test (for 24 hours prior)
- The Pap test is the best method of detecting changes to the cells of your cervix but no screening test is 100% accurate. Inaccurate test results are possible, which is why having the test performed every year is important.
Should I get a pap test?
Frequently Asked Questions about Paps
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