By: Holly L. Thacker, MD
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Do you know the difference between a Pap test and a pelvic exam? Many women think they are the same thing. But there are important differences between the two.
What is a Pap test?
A Pap test is a medical screening to detect any changes in cells on the cervix.
A doctor performs the screening by using a small plastic spatula and brush to collect cells from the cervix, which connects the uterus to the vagina. A specially trained person then examines the cells under a microscope in a laboratory to look for any abnormalities.
A Pap test is one of the most reliable and effective cancer screenings. It can find precancerous changes on the cervix that can be treated before cancer develops, or early cancer when it’s most treatable.
When to have a Pap test
Women should start obtaining Pap tests at age 21 with a three-year interval between screenings.
At age 30, if you have a normal Pap test and a negative human papillomavirus (HPV) test, you can space out your Pap tests to every five years. If results are normal your whole adult life, you may stop at age 65 but still should have a periodic pelvic examination especially if there are any symptoms.
Many women are surprised to learn that most women do not need a Pap test every year. This is to avoid over-screening women, which results in unnecessary health costs and creates the potential for false positives. These are test results that erroneously indicate abnormalities and can cause much needless anxiety.
However – and this is important — if you are a DES daughter, are HIV-positive, or have high-risk precancerous changes on Pap tests, these screening guidelines do not apply to you.
Be sure to talk it over with your doctor about the best time for you to have a Pap test.
If you receive an abnormal Pap test result, be sure to schedule a follow-up appointments with your physician.
What is a pelvic exam?
During a pelvic exam, your doctor looks for medical problems in your pelvis, vagina and the pelvic floor — the area that your hip bones encompass. Your doctor will examine your external genitalia, vagina and pelvic organs as well as your pelvic muscle floor strength.
When to have a pelvic exam
Many women do not need a pelvic exam every year. But when it takes place, it’s part of your annual well-woman visit with your physician.
But be sure to discuss with your physician whether you need a pelvic exam during your well-woman visit. You should have a pelvic exam if you have any concerns about bladder function, sexual function, experience any symptoms or have any concerns.
Some women request a pelvic exam because they have personal concerns that they want to discuss with their physician and not the person scheduling the appointment. These personal concerns can include sexual problems, pain, and/or bladder and bowel leakage. The pelvic exam can pave the way toward counseling or treatment of these concerns.
A pelvic exam also may uncover medical conditions that are producing unreported or unnoticed symptoms.
Even if a woman does not need a pap and/or a pelvic exam, she should still see her medical health provider every year.
Bottom line: Be sure to see your physician every year for a well-woman visit. Ask whether you should have a pelvic exam – and talk with your doctor about whether and when a Pap test is appropriate for you. Then be sure to follow up on any abnormalities in the pap smear.