- Pap smears test for abnormal cell change in the cervix, which could lead to cervical cancer. Pap tests can also find cell changes caused by HPV.
- Planned Parenthood, urgent care centers, OB/GYN, and The National Breast and Cervical Cancer Early Detection Program offer Pap smears.
- A complete physical exam that includes a pelvic exam may cost about $125. A Pap test adds another $40, or more if you get tests for sexually transmitted diseases. If the Pap test result isn't normal, follow-up can cost over $350.
What's a pap test?
Pap tests, often called Pap smears, test for abnormal cell change in the cervix, that could lead to cervical cancer. Pap tests can also find cell changes caused by HPV (human papillomavirus), but they don't detect HPV itself. Pap tests may be part of your regular check-up, pelvic exam, or women's wellness exam.
What does a paper smear entail?
During a Pap test, your doctor or nurse puts a metal or plastic speculum into your vagina. The speculum opens up to separate the walls of your vagina so that they can get to your cervix. Then they use a small sampler, a tiny spatula or brush — to gently collect cells from your cervix. The cells are sent to a lab to be tested.
They only take a few minutes and it typically doe not hurt. You may feel some discomfort or pressure during the test.
Who should get a pap smear?
It's typical to start getting regular Pap tests at age 21.
How often you get tested after that depends on your age, medical history, and the results of your last Pap or HPV tests. In general, these are the guidelines:
- If you’re 21–29 years old, you should get a Pap test once every 3 years (at age 25, your doctor may switch to an HPV test).
- If you’re 30–65 years old, get a Pap test and HPV test (co-testing) once every 5 years, or just a Pap test or HPV test every 3 years.
- If you’re older than 65, you may not need Pap tests anymore.
Please note that it's possible you may need to get tested more often if you’ve had problems with your cervix before, have a weak immune system, or if your mother took a medicine called DES while she was pregnant with you.
Your doctor or nurse will tell you which tests you need and how often you should get them.
Where can I get a pap smear?
Your local Planned Parenthood may offer low-cost Pap smears.
Planned Parenthood is an organization that offers sexual and reproductive health care to individuals, regardless of income. You can find your local Planned Parenthood clinic by visiting their website or by calling (800) 230-PLAN.
The National Breast and Cervical Cancer Early Detection Program
The National Breast and Cervical Cancer Early Detection Program is a federally funded program that helps uninsured and underinsured women get regular Pap smears.
The program is available to eligible women ages 21-64 who are not insured, (or whose insurance does not cover screening exams) and whose yearly income is at or below 250% of the federal poverty level.
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Women between the ages of 40 and 64 can also undergo breast cancer screening. Some women who are younger or older than these ages may also qualify based on risk factors.
Depending on your needs, services offered by the program may include:
- Pap smears (cytology)
- HPV testing
- Pelvic exams
- Clinical breast exams
- Diagnostic testing (further testing that may be needed if your results are abnormal)
- Treatment referrals (if treatment is needed based on your results)
Many urgent care centers such as FastMed, CityMD, and more, offer pap tests and other OB/GYN services.
Other women's services that can be treated at urgent care centers include:
- Urinary complaints
- Vaginal complaints (i.e. bleeding, discharge, itchiness, dryness)
- Abdominal/pelvic pain or cramping
- Abnormal menstruation
- Pregnancy testing
- Hemorrhoids & abscess
- IV fluids for dehydration
- Morning sickness
- Menopausal symptoms
- Referrals for ultrasound
- Referrals to board-certified OB/GYN and Reproductive Health specialists
If you can't afford urgent care center, you can become a Mira member for just $45/mo. Your urgent care visit will be completely covered and you will have access to low-cost lab testing and prescription discounts.
Women's Health Centers or Clinics
Women's health centers offer care and support to help women manage their health. They oftentimes have doctors and specialists offering a wide range of services, including women’s primary care, family planning, prenatal through delivery care, midwifery services, OBGYN, mammograms, screenings, postpartum care, along with other services.
Insurance is typically taken at these centers or clinics. If you are uninsured, many places will work with you so you can afford your visit. You can also see free and reduced-cost clinics in NYC.
When seeing your OB/GYN for your annual visit, they will likely perform a Pap smear.
How much does it cost to get a pap smear?
A complete physical exam that includes a pelvic exam may cost about $125.
A Pap test adds another $40, or more if you get tests for sexually transmitted diseases. If the Pap test result isn't normal, a follow-up can cost over $350.
The cost for a pap smear depends on the following factors:
- Insurance coverage
- Your location
- Your income
- Where you receive the test
At urgent care, a Pap smear may be included in the price for the visit. However, fees may be added when the sample is sent to a lab.
The cost for Planned Parenthood will depend on your income.
What happens if I have an abnormal pap test result?
If abnormal or unusual cells were discovered during your Pap smear, you would have a positive result. However, a positive result doesn't mean you have cervical cancer. What a positive result means depends on the type of cells discovered in your test.
Here are some terms your doctor might use and what your next course of action might be:
- Atypical squamous cells of undetermined significance (ASCUS): Squamous cells are thin and flat and grow on the surface of a healthy cervix. In the case of ASCUS, the Pap smear reveals slightly abnormal cells, but the changes wouldn't completely suggest that precancerous cells are present.
- With the liquid-based test, your doctor can reanalyze the sample to check for viruses known to promote the development of cancer, such as some types of HPV.
- Squamous intraepithelial lesion: This term is used to indicate that the cells collected from the Pap smear may be precancerous.
- If the changes are low grade, it means the size, shape, and other characteristics of the cells suggest that if a precancerous lesion is present, it's more likely to be years away from becoming cancer.
- If the changes are high grade, there's a greater chance that the lesion may develop into cancer much sooner. Additional diagnostic testing is necessary for this case.
- Atypical glandular cells: Glandular cells produce mucus and grow in the opening of your cervix and within your uterus. Atypical glandular cells may appear to be slightly abnormal, but it's unclear whether they're cancerous.
- Further testing is needed to determine the source of the abnormal cells and their significance.
- Squamous cell cancer or adenocarcinoma cells: This result means the cells collected for the Pap smear appear so abnormal that the pathologist is almost certain a cancer is present.
- "Squamous cell cancer" refers to cancers arising in the flat surface cells of the vagina or cervix. "Adenocarcinoma" refers to cancers arising in glandular cells. If these cells are found, your doctor will recommend a prompt evaluation.
- If your Pap smear is abnormal, your doctor may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina, and vulva.
- Your doctor also may take a tissue sample (biopsy) from any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis.