- More than 13,000 women in the United States will be diagnosed with invasive cervical cancer this year
- A routine pap exam can help women lower their risk of developing cervical cancer
- It's important to dispel myths about the pap exam so people aren't misinformed about their role in preventative care
Every year, millions of people with female reproductive organs will head to their gynecologist for a pap smear. Most of those people will see it as a routine part of their annual health exam.But if you've never experienced one yourself, the idea of a pap test can seem intimidating. Many people know the exam involves a gynecologist examining the inside of the vagina. However, not everyone is completely sure why they do this. As a result, it can be pretty confusing trying to understand or explain to someone exactly what the pap test is.For more than 60 years, pap smears have been a routine practice of gynecology in the prevention of cervical cancer. They are usually part of an overall test called a pelvic exam, which is essentially a physical check-up for the uterus, cervix, and vagina.During the pap smear portion of the exam, gynecologists retrieve a sample of cells from the cervix and have them examined for possible pre-cancerous changes.Since the exam is such a significant part of maintaining female reproductive health, it's vital that people have accurate information about it. This means dispelling certain myths about the procedure and why it's done in the first place.
Below are some things you may have thought were true about pap smears that actually aren't accurate at all.
MYTH: Getting a pap smear is always extremely painful.
This is probably the most common myth about the entire pap smear process. Even though pain thresholds vary from person to person, the truth is pap smears are often not as bad as people anticipate them to be. According to Planned Parenthood, many women report they aren't bothered by the actual cell collection process, but rather, the uncomfortable sensation caused by the speculum tool that stretches the vaginal opening. Gynecologists use these tools to keep the vagina open during the procedure. However, since the full pap test lasts only a few minutes, any discomfort a person feels will be very temporary.
It's definitely possible to bleed during an exam, but the amount of blood is usually minimal - a few drops. The experience is certainly not pleasant, but it's nowhere near as bad as a person might anticipate.Just check out this Reddit thread that discusses how painful pap smears are here. Most of the people on the thread rated their experience as practically painless.Of course, if you're still worried, talk to your doctor about your concerns. And if anything feels bad during the exam itself, make sure you say something.
MYTH: A pap test is the same thing as an HPV test.
HPV, otherwise known as human papillomavirus, is a sexually transmitted infection. It is also the leading cause of cervical cancer in adults. You've probably seen many commercials talk about the dangers of HPV that urge people to get their pap smear. Some medical professionals may use the term "cervical screening exam" as a catch-all to refer to the pap and HPV test itself. But the two tests actually look for different things.It's true both tests involve the same physical procedure for the patient. Gynecologists gently scrape the patient's cervix with a small brush to collect a cell sample that will be examined under a microscope.In a pap smear or pap test, doctors look for certain cell abnormalities (aka possible precancerous cells) when studying the sample. On the other hand, during an HPV test, doctors look for the presence of two types of viruses that could lead to cervical cancer. They are called HPV 16 and 18. Typically, they show up in the DNA or RNA of cervical cells. Since both tests are concerned with the prevention of cervical cancer, it makes sense why a person would assume they are the same. But this is simply not the case. Plus not every person with a vagina has both tests done when they see their gynecologist. In recent years, the HPV test has been considered the more thorough, accurate test for women under30 as it can detect high-risk strains of the virus before potentially precancerous cells show up on a pap test.
Of course, you might still have one question: Why do they call it a pap test, then? It turns out the exam is named for the doctor who invented it,not human PAPillomavirus. That doctor's name was Dr. George Papanicolaou, and he is credited with pioneering many reproductive health practices for women in the 1940s.
MYTH: If you get a pap test before having sex, it means you're not a virgin.
The source of confusion here is the hymen, which is a small thin layer of tissue that sits inside the vaginal opening. For years people have associated the presence of a hymen with the idea virginity. The belief is the first time a person has vaginal intercourse, the hymen will break. Some people may worry that getting a pap exam could potentially break their hymen because of the tools gynecologists use. While it's possible for this to happen, gynecologists can immediately see if their patient's hymen is still intact prior to beginning the pap test.Still it's pretty unlikely the device would break a hymen if their doctor is being gentle during the exam.Regardless, it's important to remember virginity is not a medical concept, but a social, cultural, and religious one. You should consider talking to their gynecologist if you still have personal concerns about the exam.
MYTH: Pap tests are completely unaffordable.
If you live in the United States, private insurance is required to cover pap smears since they fall under the umbrella of what's considered preventative care. However it's important to remember that depending on your insurance, you may still have a co-pay for the office visit.
The good news is there are many health clinics that offer Pap smears at little to no cost for patients.
MYTH: If a person only has one sexual partner, they don't need to get a pap test.
This is a dangerous misconception that can lead to a huge mistake. HPV isn't like other sexually transmitted infections, like chlamydia, where symptoms can show up immediately.Sometimes HPV can lie dormant for years before it shows up on a test. This means even if a person's pap smear results come back clear one year, it's possible they still carry HPV that isn't showing on the test. Dr. Laura Corio, an obstetrician and associate professor at Mount Sinai Hospital in New York, told the New York Times, "HPV never really leaves your body." And as mentioned before, if HPV is left undetected, there's a possibility it could lead to cervical cancer. This is why it's important to always get tested, even if you've been in a long-term, monogamous relationship.
MYTH: The pap test is an STI test.
Since the main concern of pap tests is cervical cancer, doctors will not automatically use them to test for sexually transmitted infections.In other words, if your gynecologist says your pap test results came back "normal," it doesn't mean you're in the clear as far as STIs go.
However, this doesn't mean your gynecologist can't check for them. if you're having physical symptoms that you're concerned about, you can tell your doctor to take a look during the pap procedure.
MYTH: You don't need a pap if you got the HPV vaccine.
Gardasil, one of the brand names for the HPV vaccine, offers protection against any types of the virus. This includes the two high-risk strains, HPV 16 and type 18, that are present in 70% of cervical cancer cases. People who have received this vaccine before they become sexually active may believe this means don't have to get a pap test. But while HPV is the leading cause of cervical cancer in young women, it isn't the only cause of cervical cancer. The American Cancer Society states that a history of smoking, an HIV infection, as well as a family history of cancer, are all factors that contribute to precancerous changes in the cervix.This means it's possible for someone to still be at risk for cervical cancer without ever contracting any of the viruses that the HPV vaccine protects against.
MYTH: You only need a pap test if you've had sexual intercourse.
According to Planned Parenthood,all people with female reproductive organs should start having annual pap tests at age 21. This is regardless of their sexual activity level, and goes hand and in hand with the idea that HPV isn't the only cause of cervical cancer. Plus, the CDC reports cervical cancer doesn't always cause symptoms, which is pretty scary. Even though it's very unlikely for a person under 30 to develop cervical cancer, it's important to get tested just in case.
MYTH: If you get an abnormal result from a pap test, it always means you have cancer.
The medical term for abnormal cells in the cervix is called cervical dysplasia. Basically, this occurs when the cells aren't following their typical movement or shape patterns. Sometimes the presence of these cells can indicate a high risk for cancer. But according to the National Cervical Cancer Coalition, abnormal pap results do not automatically mean a person has cervical cancer, nor does it mean they are guaranteed to develop it in the future. When doctors examine the results from a pap test, they classify the presence of abnormalities by the relative risk it can cause. According to the Center for Young Women's Health, some doctors may refer to the different results as normal, unsatisfactory, benign chances, and ASCUS (Atypical Squamous Cells of Undetermined Significance).Normal results are pretty self-explanatory - it means nothing unusual was in the sample. Unsatisfactory means the sample wasn't strong enough to be tested. Benign changes means that the cells are possibly inflamed due to an infection. ASCUS means there were noticeable changes in the cells.If your pap results fall under the "ACUS" category, your gynecologist may request that you have a repeat pap exam or an HPV test. If those second pap results come back abnormal, you might need a colposcopy. A colposcopy is a procedure that's sort of like an extended pap test, except during the exam, doctors physically examine your cervix with a microscope. They also typically take a biopsy, or tissue sample for further examination just to make sure there aren't any cancer cells.But in general there's no need to panic just because your test has abnormal results. Because even in the rare chance that the cells are cancerous, cervical cancer is one of the most successfully treatable forms of cancer that exists.
MYTH: Pap smears aren't even a thing anymore since gynecologists started offering HPV tests.
It's true that guidelines for how often people should get pap tests have changed. Before, the recommendation was that people with vaginas schedule a pap once every year to be safe. Now doctors believe that a three-year gap between pap smears is totally satisfactory as long as a person has had three consecutive years of normal results.While the HPV test has proven to show some advantages over pap tests, doctors told Time magazine in 2014 the pap test isn't going anywhere. It turns out it might not be a good idea to exclusively rely on the HPV test for detecting cervical cancer. This is because the test can produce positive results for the types of HPV that don't lead to cancer. Many of those types of HPV eventually go away on their own. As a result, over-testing can cause patients to feel unnecessarily worried, or even opt for treatments that cause more harm than good.For guidelines on which tests you should be getting, it's always best to consult your gynecologist.
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