Pap tests check for abnormal cells in the cervix that may lead to cervical cancer. They also detect certain types of human papillomavirus (HPV), which is an STD.
Doctors recommend that menstruating women ages 21 to 65 get a Pap test every three years and an HPV test or co-test every five years. The Pap test can detect asymptomatic genital infections, such as trichomoniasis and gonorrhea.
Cervical cancer
Cervical cancer starts in the cells that line the cervix. Most of these cancers start as a precancerous condition called dysplasia. A Pap test detects these abnormal cells and can often find them before they turn into cervical cancer.
Doctors usually treat this precancerous condition, but sometimes they will need to remove the cells that cause it. This is a procedure called a biopsy. Your doctor will use a long swab to collect cells from your cervix and send them to the lab.
Almost all cervical cancers are caused by the human papillomavirus, or HPV. You can have an HPV test done separately or get it with your Pap test, known as co-testing. You should get co-testing every five years starting at age 30.
Your doctor might also ask you to have a colposcope exam, a pelvic exam that lets them look at the cervix with a microscope that magnifies your cells 8 to 15 times. Your doctor may stain your cervix with a dye or acetic acid so they can see the cells better and might take a sample of your cervix for testing in a procedure called a cone biopsy. They might also use a tool called the loop electrosurgical excision procedure (LLETZ), which uses an electric current to help remove cells.
Chlamydia
Chlamydia is an infection that affects the reproductive organs. It can cause anal or vaginal bleeding, pain in the vulva and a discharge from the penis. The bacterium can also be passed on from a woman to her unborn child, leading to a miscarriage or severe eye infection (conjunctivitis) in newborns. Chlamydia is very common among people who are sexually active, especially young women. Infection with chlamydia typically has no symptoms, so many people don’t know they have it. This means that chlamydia is often undetected and untreated, which can lead to complications.
To test for chlamydia, doctors use a swab from the inside of the vagina or urethra. They may also swab other areas if there is a chance of an infection. The sample is sent to a lab to be checked for the presence of Chlamydia bacteria. Newer, nonculture tests that don’t require a culture can detect these bacteria in the sample much more quickly than older methods.
The Centers for Disease Control and Prevention recommend that all sexually active adults, particularly those ages 25 or younger, get tested for chlamydia at least once each year. This includes those who have had a previous chlamydia infection and those who have new or multiple sexual partners.
Gonorrhea
Gonorrhea is a very common bacterial infection that can easily be treated with antibiotic medicine. It spreads through vaginal, anal and oral sex and can also be carried in semen (cum) or pre-cum. Gonorrhea can cause serious long-term health problems if not properly treated, including pelvic inflammatory disease in women and infertility. It can also lead to eye infections, such as conjunctivitis, in newborn babies if the infection is transmitted during delivery.
A smear test for gonorrhea detects the bacteria Neisseria gonorrhoea by looking at cell samples using a microscope. Symptoms of gonorrhea include pain, itching or burning on the vulva, and discharge that may be bloody or yellow.
The best way to prevent gonorrhea is by using condoms during sexual contact. Avoid having anal or oral sex and limit your number of sexual partners. People at high risk of gonorrhea include those who have a new sexual partner, multiple sexual partners or are not in a monogamous relationship. Gonorrhea can increase a person’s risk of infecting others with HIV, which causes AIDS. Regular testing is important for those at high risk.
Hepatitis B
Hepatitis B is a virus that affects the liver. It is spread through contact with contaminated blood or body fluids. This includes unprotected sex, sharing needles or drug paraphernalia, and mother-to-child transmission during childbirth.
Hepatitis B can be detected using a blood test that measures levels of the antibodies that fight against the virus. A positive result indicates that you have a current infection or immunity to the virus. A negative result means that you have a past infection or are at low risk for developing one.
The smear test for Hepatitis B is usually performed at the same time as your cervical screening test. A nurse or doctor will gently brush a sample of cells from your cervix and put them on a slide. They will then send the slide to a lab for testing.
If your smear results are normal, you will be invited back for cervical screening tests in 3 or 5 years depending on your age. It’s important to go for your smear tests regularly because they can help find abnormal cell changes in the cervix before they become cancerous.
Human papillomavirus (HPV)
HPV is a common virus that causes warts on the genitals and anus. Some strains can lead to cancer, especially cervical cancer. Early detection and treatment prevents the cancer from developing. Most women and some men infected with HPV do not have any symptoms.
A Pap test collects and tests cells from the surface of the cervix to look for changes that could become cancer. It also finds precancerous cells (cervical dysplasia) and other abnormalities. The Pap test may be used alone or with an HPV test to find out if you have high-risk types of HPV that can cause cervical cancer. The Pap test and HPV test are sometimes combined into one test called a cotest.
Most women between the ages of 30 and 49 need to have routine Pap tests. Your doctor will decide how often you need a Pap test based on your age and health history. Your doctor might recommend that you get a Pap test every three years without an HPV test or every five years with a Pap test and HPV test.
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