Pap tests explained

The Pap test is a quick and simple test that checks for changes to the cells of the cervix that may lead to cervical cancer. In Australia, regular Pap tests save more than 1,200 women each year from cervical cancer. Most women who develop cervical cancer either have not had a Pap test or have not had them regularly.

All women aged between 18 and 70 years who have ever been sexually active should have a Pap test every two years. This includes women who have had the cervical cancer vaccine.

Cervical cancer
Cervical cancer is almost always linked to the human papilloma virus (HPV), which is spread through genital skin-to-skin contact during sexual activity. HPV infection is so common that it should be considered a normal part of being sexually active. Four out of five women will have HPV at some time in their lives.

Although HPV is very common, most women with HPV will not develop cervical cancer. In most cases, HPV clears naturally from the body. This can take one to two years and doesn’t require treatment. Occasionally the virus can persist in the cervical cells and causes cell damage. If these changes are left undetected and untreated, the risk of developing cervical cancer increases.

The Pap test procedure
A Pap test is a simple and quick procedure that is performed by a doctor, nurse Pap test provider or gynaecologist.

During the test, an instrument called a speculum is gently inserted into the vagina. This allows the cervix (the neck of the womb) to be clearly seen. A small spatula or a tiny brush is then inserted to collect cells from the cervix. These cells are smeared onto a glass slide and sent to a laboratory for analysis. The results are usually available within a week.

Pap tests can be uncomfortable but should not hurt. If you feel any pain, tell your doctor, nurse or gynaecologist immediately.

An abnormal Pap test result
An abnormal Pap test result means that either a ‘high-grade’ (more serious) or ‘low-grade’ (less serious) abnormality has been found and that some of the cells of the cervix differ in some way from the normal cells. It rarely means cervical cancer is present.

For many women, more frequent Pap tests will be required for a period of time after an abnormal result. During this time, the cells of the cervix may heal themselves. Regular Pap tests will check for this and also pick up any further changes that might occur. The length of time between your repeat Pap tests will depend on the type of problem you have. Ask your doctor for advice on the right length of time for you.

Cells changes
If minor changes persist or if a ‘high-grade abnormality’ is found, you will be referred to a gynaecologist for an examination called a colposcopy. A colposcope (an instrument that magnifies the cells of the cervix) gives a closer view of the extent and nature of the problem.

There are various treatment options of high-grade abnormalities – your doctor will recommend what’s right for you.

Pap tests are still required even if vaccinated
Two-yearly Pap tests are very important for all women, including those who are vaccinated. The cervical cancer vaccine protects against the most common types of cancer-causing HPV, but not all, and cervical cell changes can still occur.

Where to get help

• Your doctor
• Your local community health centre or women’s health nurse
• Family Planning Victoria Tel. (03) 9257 0100
• Well Women’s Clinics at the Royal Women’s Hospital and the Mercy Hospital for Women
• PapScreen Victoria
• The Cancer Council of Victoria Information and Support Line Tel. 131 120

• All women aged between 18 and 70 years should have a Pap test every two years, vaccinated or not.
• An abnormal result rarely means cancer. Discuss your results with your doctor or nurse.

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