A Pap test, or Pap smear, is the most effective screening test for cervical cancer. It's often part of a pelvic examination. Regular testing can help your doctor find and treat abnormal cell changes on your cervix before they develop into cancer.
A high-risk type of the human papillomavirus (HPV) causes most cases of cervical cancer. Girls and women ages 9 to 45 can get the HPV vaccine to prevent infection with the types of HPV that are most likely to cause cervical cancer. HPV vaccine recommendations and cost coverage vary from province to province.
Even if you've already had the HPV vaccine, you still need Pap tests because the vaccine doesn't protect you from all types of HPV. Women who have had the HPV vaccine should follow the same Pap test schedule as women who have not had the HPV vaccine.
Cervical cancer screening programs in your area
- Alberta: Go to the Screening for Life Cervical Cancer webpage at http://screeningforlife.ca/cervical-cancer-at-a-glance.
- British Columbia: Go to Screening BC's webpage at www.bccancer.bc.ca/screening/cervix.
- New Brunswick: Go to New Brunswick Cervical Cancer Prevention and Screening Program webpage at http://www2.gnb.ca/content/gnb/en/departments/health/NewBrunswickCancerNetwork/content/NewBrunswickCervicalCancerPreventionScreeningProgram.html.
- Ontario: Go to Cancer Care Ontario's Cervical Cancer Screening webpage at www.cancercare.on.ca/pcs/screening/cervscreening.
- Saskatchewan: Go to the Saskatchewan Cancer Agency's webpage at www.saskcancer.ca and select Screening.
If your area is not listed, go to www.cancerview.ca and select "Prevention and Screening." Some areas don't have cervical cancer screening program webpages, or programs may be in development. Talk with your doctor about when and how often to have Pap tests for cervical cancer screening.
When to start Pap tests
Guidelines for when to start having Pap tests vary from province to province. Talk with your doctor about when to start having Pap tests. If you are sexually active and wait to have a Pap test, it's still a good idea talk to your doctor about birth control and sexually transmitted infection prevention.
How often to have Pap tests
Guidelines for how often to have a Pap test vary from province to province. Talk with your doctor about how often you need to have a Pap test.
Below are examples of screening recommendations from the Canadian Task Force on Preventive Health Care and the Public Health Agency of Canada. These recommendations are different from each other. These screening recommendations may not be used in your area.
The Canadian Task Force on Preventive Healthcare recommends:footnote 1
- If you are younger than 25, routine screenings are not recommended.
- If you are 25 to 69, screening is recommended every 3 years.
- If you are 70 or older and have had 3 negative Pap tests results in a row in the last 10 years, screening is no longer needed. If you haven't had regular screenings continue getting tested until you have 3 negative test results.
The Public Health Agency of Canada recommends:footnote 2
- If you are sexually active, have a Pap test every 1 to 3 years, depending on the guidelines in your province.
- If you have had a hysterectomy, talk to your doctor about whether you need a Pap test.
- If you stop having sex, continue to have regular Pap testing.
Women who need more testing
After any abnormal Pap test, your doctor will recommend follow-up to monitor the cell changes.
- Some women need a human papillomavirus (HPV) test.
Experts agree that some women may need to be tested more often if they:
- Were exposed to DES (diethylstilbestrol) before birth (prenatal exposure).
- Have HIV (human immunodeficiency virus).
- Have a history of abnormal Pap tests or cervical cancer.
- Have a weakened immune system.
For more information, see the topic Pap Test.
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- Canadian Task Force on Preventive Health Care (2013). Recommendations on screening for cervical cancer. Canadian Medical Association Journal, v185(1): 35-45. Also available online: http://canadiantaskforce.ca/guidelines/screening-for-cervical-cancer.
- Public Health Agency of Canada (2009). What should I know about cervical cancer? Public Health Agency of Canada. http://www.phac-aspc.gc.ca/cd-mc/cancer/cervical_cancer_about-cancer_col_uterin_sujet-eng.php. Accessed January 10, 2014.
Other Works Consulted
- Centers for Disease Control and Prevention (2013). Cervical Cancer Screening With the HPV Test and the Pap Test in Women Ages 30 and Older. Accessed Sept. 17, 2013: http://www.cdc.gov/cancer/hpv/pdf/HPV_Testing_2012_English.pdf.
- Sawaya GF, et al. (2015). Cervical cancer screening in average-risk women: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Annals of Internal Medicine, 162(12): 851–859. DOI: 10.7326/M14-2426. Accessed June 19, 2015.
Current as ofDecember 19, 2018
Author: Healthwise Staff
Medical Review: Sarah Marshall MD - Family Medicine
Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Current as of: December 19, 2018