Dear Alice,

Does a virgin need to have a Pap smear? Is cervical cancer the only disease a Pap smear detects? What are the means of contracting cervical cancer and any other possible diseases detected by the Pap smear?

—New at this

Dear New at this,

It is commonly recommended that women have their first gynecological exam when they're 21, regardless of whether they have been sexually active or not. Routine pelvic examinations include both an internal and an external exam. Part of the internal exam consists of a Pap smear (also called a Pap test). The Pap smear is a screening test for changes in cervical cell growth that may lead to cancer. The test does not actually detect disease, but it identifies inflammation and infection in the cervical area that may be evidence of abnormalities in the cervical cells.

During the exam, the clinician will gently insert an instrument called a speculum into the vagina. The clinician will then use a cotton-tipped swab or other similar long-stemmed instrument to collect a sample of the cells in the cervix. Some women feel a slight cramping or pressure when the speculum is inserted and their cervix is touched. The collected cells are mounted on a slide and sent to a lab, where it will be examined by a technician. The Pap test does not test for pregnancy, sexually transmitted infections, vaginal infections or other types of gynecological problems. However, a test for sexually transmitted infections, including HPV (Human Papilloma Virus - the most common cause of cervical cancer), can be requested at the same time as the pap smear, in which an additional swab sample may need to be taken.   

If there are abnormal cells present on the cervix, HPV may be the potential reason for any cell changes that can lead to cervical cancer. At the exam, the clinician may discuss the HPV vaccine, which is a three-series injection that can prevent certain types of the human papillomavirus (including those most likely to lead to cervical cancers).

It is recommended that women get routine pelvic exams including Pap tests once every three years. If you are 21 and have never had a Pap test or are interested in the HPV vaccine, Columbia Morningside students can call Medical Services at 212-854-2284 or log-in through Open Communicator to make an appointment for an exam. Columbia Medical Center students can contact Student Health Services at 212-305-3400. If you are not a student at Columbia, contact your health care provider or school's health service for an appointment.


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