Australian Government Department of Health
National Cervical Screening Program
Photos of Women

The Pap Smear

Answers to commonly asked questions about Pap smears.

  1. What is a Pap smear?
  2. What are the symptoms of cervical cancer?
  3. Who is at risk?
  4. What is the cause of cervical cancer?
  5. How effective is the Pap smear?
  6. How often should I have a Pap smear?
  7. Menopause - do I still need a Pap smear?
  8. Hysterectomy - should I still have a Pap smear?
  9. Should women with disabilities have Pap smears?
  10. When should I stop having Pap smears?
  11. How much does it cost?
  12. Where can I go to have a Pap smear?

What is a Pap smear?

In 1928, Dr Papanicolaou discovered that cells in the cervix change in appearance before they become cancerous. The Pap smear, named after the doctor, is used to check changes in the cervix (the neck of the womb) at the top of the vagina. It is a screening tool to find early warning signs that cancer might develop in the future.

The Pap smear is a simple procedure. Cells are collected from the cervix and placed (smeared) onto a slide. The slide is sent to a laboratory where the cells are tested for anything unusual. If abnormal changes are found at screening, further tests will be done to see if treatment is needed.

The Pap smear is not for diagnosing cancer, but rather, for finding early changes which might become cancer.

A Pap smear only takes a few minutes. No drugs or anaesthetics are required and it can be done by a general practitioner, nurse or women's health worker.

The Pap smear does not check for other problems in the reproductive system including ovarian cancer. It is not a check for sexually transmitted infections. Women who are worried that they may have a sexually transmitted infection should talk to their general practitioner about the tests and treatments available.
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What are the symptoms of cervical cancer?

In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap smear.

If you have any abnormal vaginal bleeding (such as intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your general practitioner.
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Who is at risk?

All women with a cervix who have ever had sex at some time in their life are at risk of cervical cancer. About half the new cases of cervical cancer diagnosed each year are in women over 50 years of age. More women over 50 years of age die from cervical cancer because their cancer is diagnosed later when treatment is more difficult.
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What is the cause of cervical cancer?

Human Papillomavirus (HPV), a sexually transmitted infection which in most cases (80%) is cleared by the body’s immune system in 8-14 months. The presence of HPV may be detected by the Pap smear. Some women who have persistent infections may develop abnormalities of the cervix. This is why it is important to have a regular Pap smears.
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How effective is the Pap smear?

Regular Pap smears every two years can help prevent up to 90 per cent of the most common type of cervical cancer.

Like all screening procedures, the Pap smear has limitations. Sometimes it will not detect early cell changes because the smear did not contain enough abnormal cells. Sometimes samples are difficult to interpret due to blood or mucus on the slide. If this occurs, the general practitioner or nurse may need to take another Pap smear.
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How often should I have a Pap smear?

All women over 18 who have ever had sex are advised to have a Pap smear every two years, even if they no longer have sex.

As the most common type of cervical cancer usually takes up to 10 years to develop, there is little advantage in having a Pap smear more frequently than every two years.

Your general practitioner may recommend more frequent Pap smears if a previous smear showed significant cell changes or you experience problems, such as bleeding or pain after sex.
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I’ve been through menopause; do I still need to have a Pap smear?

Yes, the risk of getting cervical cancer is the same even after menopause so it is important to keep having Pap smears every two years, even after menopause.
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I've had a hysterectomy. Do I still need to have Pap smears?

Following a hysterectomy, women should discuss their ongoing need for cervical screening with their doctor. Women who have had a hysterectomy usually do not require further Pap smears. However, in some cases, Pap smears may still be needed.

Women who have had a total hysterectomy, that is, the uterus and cervix removed, and have ever had treatment for severe changes on the cervix, are recommended to continue to have smears taken from the upper vagina (known as vault smears). Women who have had a hysterectomy but have never had a Pap smear should also have a vault smear. Women who have had a partial hysterectomy, where the cervix is not removed, should still have a Pap smear every two years.

Many women do not know exactly what type of hysterectomy they had. If you are not sure, it is important to find out. If your doctor has no records of the operation, an internal examination or a cell sample may be needed.
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Should women with a disability have Pap smears?

Yes, all women with a cervix who have ever had sex are at risk of cervical cancer. One of the key objectives of the National Cervical Screening Program is that its services are accessible to all Australian women.

In all states and territories women have access to a free telephone helpline (13 15 56) for further information on cervical screening, including access issues. This ensures women with disabilities can be directed to a practitioner who is best able to meet their individual needs.

In several states and territories, strategies have been put in place to address the needs of women with disabilities who wish to have a Pap smear, including:
  • purchase of adjustable examination couches;
  • development of resources specifically designed for women with physical (including visual and hearing) and/or intellectual disabilities;
  • referral to Pap smear providers who can meet women’s special needs in terms of physical and intellectual disabilities.
For more information about access to National Cervical Screening Program services ring 13 15 56 (for the cost of a local phone call). Alternatively, contact your state or territory National Cervical Screening Program on Useful Links page.
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When should I stop having Pap smears?

If you are 70 years or over and have had two normal Pap smears in the last five years, you do not have to keep having Pap smears, unless you wish to do so. Women who are over 70 years who have never had a Pap smear, or those who request a Pap smear, can make an appointment to be screened.
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How much does it cost?

There are two costs involved in having a Pap smear: the consultation with the doctor or nurse; and the Pap smear pathology test. Many general practitioners, clinics, health centres and pathology providers (laboratories) ‘bulk bill’ which means there is no cost for the Pap smear and/or the consultation.

If a fee is charged, the cost to you will be the difference between the Medicare rebate and the general practitioner’s and pathology provider (laboratory) fees. In some cases you may be asked to pay the full fee and then claim a rebate from Medicare.

Ask for information about the cost when you make an appointment.
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Where can I go to have a Pap smear?

To make an appointment to have a Pap smear, you can contact:
  • your general practitioner;
  • a community or women’s health centre;
  • a family planning or sexual health clinic;
  • a women’s health nurse; or
  • an Aboriginal Medical Service.
For further information contact your doctor,
health centre or family planning clinic, or phone 13 15 56 (for the cost of a local call).

Page currency, Latest update: 19 November, 2013