What is a pap test? Here’s what doctors are looking for

Pap tests are a central part of sexual health for Canadians and keeping up with screenings is crucial to catch any early signs of cervical cancer, according to health professionals.

But misconceptions about why and how often pap tests are needed may cause some people to miss their tests.

It’s important to understand the purpose of the procedure and to make time for it in your schedule, said Elizabeth Holmes, manager of health policy at the Canadian Cancer Society.

“We get busy, and we’re just like: ‘oh I did it a couple of years ago, it’s fine,’” she said. “But it is really important to do it through your cervical cancer screening program to and do it every two to three years so that we can keep an eye out for abnormal cells,” she explained. 

Generally, depending on the province or territory you live in, practitioners will recommend you plan for the screening every two to three years, said Holmes. 

“Think of it as a part of your self-care, as part of taking care of yourself to check off your list,” she said.

“And if you haven’t had a great experience, then find a doctor you’re comfortable with and be sure to share your past experience with them, about why you’re nervous about it.”

Why are pap tests needed?

The purpose of a pap test is to screen for signs of cervical cancer by detecting cell changes in the cervix, said Dr. Rachel Spitzer, an obstetrician and gynecologist at Mount Sinai Hospital and Women’s College Hospital in Toronto.

“Pap smear screenings are usually for people who don’t have any symptoms or problems,” said Spitzer, who’s also an associate professor at the University of Toronto. 

The development of cervical cancer is usually directly related to the human papillomavirus (HPV), explained Spitzer. “It’s looking for usually HPV-mediated … changes to the cells of the cervix long before cancers develop, so they can be treated and prevented,” she said. 

In Canada, 1,350 women were diagnosed with cervical cancer in 2019 and an estimated 410 will die from it, according to the Canadian Cancer Society. But scheduled pap tests and the HPV vaccine are ways to prevent the disease, according to the society. 

“Most people don’t know that HPV is what causes cervical cancer,” said Dr. Amanda Selk, an obstetrician and gynecologist based in Toronto. “And now we have a vaccine … and that can actually prevent you in life from ever getting the virus, which can help you for not getting cancer.”

At what age do I need a pap test?

The age when a first pap test is recommended, and how often the tests should be, depends on where you live in Canada, said Selk.

“The standard is, not before 21 and you have to have been sexually active. So if you’ve never had any sexual contact of any kind then you can wait,” she explained. 

Some provinces, like Alberta and B.C. have raised the age for a first screening to 25, and that is also under consideration in Ontario, P.E.I. and NL. 

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