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Cervical cancer screening

Pap smear: what to expect

A Pap smear collects a few cells from the cervix with a small brush or swab so a lab can check them for changes that could turn into cancer. The same sample can be tested for HPV. It takes a few minutes, needs little preparation, and may feel uncomfortable but should not be painful. Your doctor decides which test you need and when. (MedlinePlus, 2024) (NCI, 2025) (OWH, 2025)

Pap test, HPV test or both

Cervical cancer screening can be a Pap test, which looks for abnormal cells, an HPV test, which looks for the high-risk HPV types that cause most cervical cancers, or both together (co-testing). All of them use cells taken from the cervix in the same way. (ACOG, 2026) (NCI, 2025) A Pap smear is often done during a pelvic exam, but a pelvic exam does not always include one, so ask whether you will have it. (MedlinePlus, 2024) Which test you have and how often depends on your age and history; see cervical cancer screening.

How to prepare

  • For two days before the test, ACOG and MedlinePlus advise no douching, no vaginal sex, and no vaginal medicines, creams, birth control foam or jelly, or other vaginal products; MedlinePlus also lists tampons. ACOG says douching or vaginal medicines may wash away or dilute abnormal cells. (ACOG, 2026) (MedlinePlus, 2024)
  • Your period: the sources differ. MedlinePlus says not to have the test during your period because it may affect the results, and suggests about five days after your period ends. ACOG says testing during a period is possible but best scheduled for another time, and the Office on Women's Health says it is better to be tested than to miss the appointment; call the office if you are not sure. (MedlinePlus, 2024) (ACOG, 2026) (OWH, 2025)
  • Emptying your bladder before the test can make it more comfortable. (OWH, 2025)
  • If a past sexual assault or abuse makes exams hard for you, tell your doctor or nurse before the test, while you are still dressed; they can talk with you about ways to make it easier. (OWH, 2025)

What happens during the test

  1. You undress from the waist down (or completely) and lie on your back on the exam table with your knees bent and your feet in footrests. (MedlinePlus, 2024) (NCI, 2025)
  2. The provider gently inserts a plastic or metal speculum into the vagina and opens it to see the cervix. This may cause pressure or cramping. (MedlinePlus, 2024) (OWH, 2025)
  3. A small, soft brush, swab or tiny spatula collects cells from the cervix. This usually does not hurt. (MedlinePlus, 2024) (NCI, 2025)
  4. The cells go to a lab. If an HPV test was ordered, the same cells are tested for HPV. (NCI, 2025) (OWH, 2025)

The test usually lasts about 5 minutes. (OWH, 2025) If you have never had sex or have pain when something is put into your vagina, you can ask for a smaller speculum. (OWH, 2025) The pelvic exam may also include checking the size, shape and position of the uterus and ovaries. (NCI, 2025)

Collecting the sample yourself

For HPV testing, you may be able to collect the sample yourself during your appointment instead of having the speculum exam; ask your provider whether this is an option. (NCI, 2025) ACOG says self-collection kits are approved for women aged 25 to 65. (ACOG, 2026) Which kits are approved and where they can be used: at-home and self-collected HPV tests.

Afterward

You may have some mild discomfort and very light bleeding or spotting afterward; MedlinePlus says there are no known risks to having a Pap smear. (MedlinePlus, 2024) (OWH, 2025)

When results come

Results usually come back in about 1 to 3 weeks, and most are normal. If you have not heard after 3 weeks, call and ask. (NCI, 2025) (OWH, 2025) An abnormal result does not mean you have cancer. (ACOG, 2026) (MedlinePlus, 2024) A result can also be "unsatisfactory" if the sample had too few cells or they were hidden by mucus, in which case you may be asked to repeat the test in a few months. (MedlinePlus, 2024) What each result means and what comes next: Pap and HPV test results.

Who still needs it

The USPSTF recommends screening from 21 to 65. It recommends against screening people older than 65 who have had adequate prior screening and are not otherwise at high risk, and people who have had a hysterectomy with removal of the cervix and no history of high-grade precancer or cervical cancer. Its 2018 recommendation is final; an update is in progress. (USPSTF, 2018) ACOG adds that you should keep being screened after a hysterectomy if your cervix was not removed, or if you have had high-grade cell changes or cancer. (ACOG, 2026) Having had the HPV vaccine does not change the advice: keep following the screening schedule for your age. (ACOG, 2026) More on stopping: when can you stop screening.

Cost and coverage

Medicare Part B covers a Pap test and pelvic exam once every 24 months in most cases, or once every 12 months if you are at high risk or are of child-bearing age and had an abnormal Pap test in the past 36 months. It covers an HPV test with the Pap test once every 5 years if you are 30 to 65 and have no HPV symptoms. You pay nothing if your provider accepts assignment. (Medicare.gov) The Office on Women's Health says most insurance plans cover Pap and HPV tests with no copay, coinsurance or deductible. (OWH, 2025) More: preventive screenings covered by insurance.

Questions people ask

Does a Pap smear hurt?

It should not be painful, though some people find it uncomfortable. You may feel pressure or cramping when the speculum goes in; the brush or swab usually does not hurt. If you have pain when something is put into your vagina, or have never had sex, you can ask for a smaller speculum. (MedlinePlus, 2024) (OWH, 2025)

How long does a Pap smear take?

The test itself usually takes about 5 minutes, and the pelvic exam it is part of takes only a few minutes. (OWH, 2025) (NCI, 2025)

Can I have a Pap smear on my period?

The sources differ. MedlinePlus says not to have it during your period because this may affect the results, and suggests about five days after your period ends. ACOG and the Office on Women's Health say it is possible but best scheduled for another time, and OWH adds that it is better to be tested than to miss the appointment. If you are not sure, call the office. (MedlinePlus, 2024) (ACOG, 2026) (OWH, 2025)

Is bleeding after a Pap smear normal?

Light spotting or very light bleeding afterward can happen. MedlinePlus says there are no known risks to having a Pap smear. (MedlinePlus, 2024) (OWH, 2025)

When will I get my Pap smear results?

Usually in 1 to 3 weeks. If you have not heard after 3 weeks, call your provider's office and ask. (NCI, 2025) (OWH, 2025)

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