Maybe you’ve seen the new magazine ad that reads, “If you’re a gambling woman, then getting just a Pap test is fine.”And maybe you thought Huh? Our response exactly. It’s an ad for the HPV (human papillomavirus) test–which is often given in conjunction with a Pap–and it probably has a lot of women puzzled about what the Pap does and doesn’t do,says Elizabeth Gunther Stewart, M.D., assistant professor of ob/gyn at Harvard Medical School in Boston. We spoke with leading doctors to clear up the confusion–and help you get the most accurate Pap.
1.Know what the Pap does. This test detects precancerous and cancerous cervical cells only. It doesn’t test for ovarian or uterine cancer, sexually transmitted diseases (STDs), or yeast or bacterial infections.
2.Get tested at the right time. If you’re under 30, you should get a Pap every year. If you’re over 30 and have had three normal test results in a row, you need to be screened only every two to three years. Studies have shown that for women over age 30 who’ve had normal Paps, a Pap every other year is just as effective as an annual test at catching abnormalities. “In fact, getting Paps more frequently increases the odds of detecting minor abnormalities,which can lead to unnecessary procedures,” says Mark Spitzer, M.D., an ob/ gyn and president elect of the American Society for Colposcopy and Cervical Pathology. But you should still see your gyno every year for breast and pelvic exams.
3.Take pre-Pap precautions. Schedule your appointment for a few days after your period ends, and refrain from having sex or inserting any creams or lubricants into your vagina for two days before the test. Any lingering blood,semen, or cream can obscure abnormal cells, increasing the risk that your Pap will read as a false negative (meaning“normal,” when it may not be).
4.Request the most precise Pap. The liquid Pap is 10 percent to 20 percent more accurate than the older type,which uses a dry slide. Although the liquid Pap has been around for almost a decade and most doctors use it, confirm with your ob/gyn that she’s one of them, says Stewart.
5.Don’t stress if you need the HPV test. No matter what your age, if your Pap results aren’t clear or are mildly abnormal, your doctor will run an HPV test (the test that’s currently being advertised) on your liquid Pap sample to find out if you harbor a high-risk strain. The reason: HPV, a symptomless STD that more than half of the population gets at some point in their lives, can cause cervical cancer. Of the more than 100 different strains of HPV, however, only a few can trigger cancer-causing cells in your cervix. And even if you do test positive for HPV,there’s a more than 50 percent chance that your immune system will get rid of this infection–which has no cure–on its own. Most likely, your doctor will monitor you to make sure precancerous cells don’t form.
6.Remember that cervical cancer is preventable. If your Pap is abnormal from the get-go or if you continue to test positive for HPV for a year, your doctor will perform a colposcopy–a more thorough pelvic exam. She may need to do a biopsy. If the results show precancerous tissue, she can completely remove it in her office, via freezing,cutting, or laser. Pain and cramping are common for a short time afterward.
7.Check on your results. A New York City hospital recently failed to notify 307 women about their abnormal Pap results. But don’t panic: “Most doctors have excellent systems for following up on abnormal results, because the risk of being sued is high if they fail to inform a patient that something is wrong,” says Paula J. Adams Hillard, a professor of ob/gyn at the University of Cincinnati College of Medicine. “Still, it doesn’t hurt to call for your results.”
For an accurate Pap result, don’t have sex two days prior to your test.