Does a Pap Test Screen for STIs?

When it comes to women’s health, regular screenings are essential for early detection and prevention. A pap (Papanicolaou) test, also called a pap smear, is one of the most well-known early screening tests for women to test for cervical cancer.

It’s important to catch issues before they become cancerous. According to the Canadian Cancer Society, about 1,600 Canadian women will be diagnosed with it this year, and about 25% will die from it. 

The test works by detecting abnormal cells in the cervix (the cervix is the opening of the uterus, which connects to the vaginal canal) before they turn cancerous. But abnormal cells aren’t always cancerous — they could be a sign of an infection or another problem and can sometimes heal on their own. Most abnormal changes in cervical cells are due to the Humanpapilloma virus (HPV).

While pap tests are mostly about detecting cancerous cells, many people wonder: does it also screen for sexually transmitted infections (STIs)? In this guide, we’ll cover what a pap test can and cannot do, so you can make informed decisions about your health. 

How do pap tests work?

Generally, pap tests take place at your family doctor’s office. You’ll undress from the waist down, cover up with a hospital gown, lie on the table, and place your feet in stirrups. Your healthcare provider will use a speculum to spread the walls of the vagina so they have access to the cervix, and with a swab or another small device, your provider will gently scrape cells from the cervix wall and place them in a vial to be sent to a lab for testing.

The importance of regular pap tests

A pap test is encouraged every three years for people with female reproductive organs who are 25 years old and older and are (or have been) sexually active. There are some risk factors that may require testing earlier; check with your healthcare provider to discuss your risk. 

Previously, pap tests were recommended every year starting at age 21 in Canada, but research showed annual screenings did not reduce the rate of cervical cancer since it can take years to develop. So, the recommended interval for paps has now increased to three years, meaning it’s easier than ever to stay on top of cervical cancer screening. 

More recently, with the introduction of HPV vaccines cervical cancer risk has reduced up to 90%. HPV testing has shown to be a promising test to detect early changes due to the majority of changes being linked to HPV. Canada is seeing formal changes in these screening guidelines delaying the start of screening to 25 and including testing for HPV like screening in the USA and other countries. 

Every woman should be diligent about getting regular pap tests — they can catch changes in cervical cells and, when necessary, these cells can be treated before they develop into cervical cancer. Even if you feel healthy, have no symptoms, are no longer sexually active, have had only one sexual partner, or have been through menopause, it’s still important to get a pap test since abnormal cells can develop at any time.

However, women over 70 can stop having tests if they’ve had three normal results in the past decade. Women who’ve had a hysterectomy can talk to their doctor about if pap tests are still recommended.

Can a pap test detect STIs?

Pap tests check for abnormal cells like the ones seen in cervical cancer. A pap test doesn’t detect any STIs, like chlamydia or gonorrhea. Although not collected on the same swab, when having a pap test done it is often a convenient time to discuss a need for STI testing – as another swab can be easily used at the same time. HPV is among the top three most common sexually transmitted infections in Canada (with chlamydia being the most common) and is a common prerequisite for cervical cancer. It is anticipated that HPV testing, a superior test, will replace pap screening. 

How does an HPV test work?

An HPV test is often done with a pap test because the tests are similar—they both involve a speculum and a swab, collecting cells, and sending them to the lab for testing. 

It’s common for a pap or HPV test to cause mild bleeding, due to the scraping of the cervix to extract the cells. Talk to your healthcare provider if you have symptoms such as heavy bleeding,  foul-smelling discharge, fever, chills, or abdominal pain. 

Your healthcare provider will likely explain what will happen if the test detects abnormal cells (you’ll likely need to have another test). They’ll be in touch in a few days when your results are available.

Note: There’s an HPV vaccine that can help prevent your risk of cervical cancer by up to 90%. Speak to a primary care provider to discuss your options. 

Types of STDs to be tested for

It’s important to note the difference between STDs (sexually transmitted diseases) and STIs (sexually transmitted infections) since the terms are often used interchangeably. The term STI is now more common than STD, as it is considered more encompassing and includes infections that may be asymptomatic.

An infection occurs when a virus, bacteria, or parasite enters the body, and your immune system fights it off or tries to. A disease occurs when an infection damages your body and leads to illness. STIs don’t always turn into diseases — but they also don’t always cause symptoms, which is why it’s important to get regular STI testing.

In most cases, STIs can also be easily treated or cured with medicine. You can also get tested for HIV, syphilis, chlamydia, gonorrhea, and hepatitis B and C.

Based on your symptoms and history of sexual activity, your healthcare provider will recommend the best tests for you.

Who should get tested for STIs?

If you fall into any of the following categories, you should get an STI test:

• you are sexually active
• you had sex without a condom
• you or someone you had sex with has STI symptoms
• your current or past partner has or had an STI
• you have shared needles with someone

What to expect during an STI test

Your doctor or healthcare provider will ask you about your sexual activity so they can decide the type of testing you may need — they may ask about symptoms, sexual partners, the type of sex you’re having, and the protection you use. Depending on the tests you need and where you are, your provider may: 

• Collect a urine test
• Order a blood test and/or a 
• Collect a sample with a cotton swab 
• Perform an external exam to check for bumps or sores
• Use a speculum to look inside the vagina or visualize the cervix. 

Where to get comprehensive STI testing

To get tested for an STI, you can visit your healthcare provider, a sexual health clinic, a local public health unit or a walk-in clinic. If you’re looking for guidance on where to get tested, speak to a primary care provider — such as a doctor or nurse practitioner — directly on Maple. They can give you insight and recommend next steps.  

Importance of regular STI screenings

Getting tested for STIs is often the only way to know if you have an infection and need treatment since many times people don’t experience symptoms. Plus, STIs are contagious — passed from person to person through sexual contact via bodily fluids or by touching the infected part of a person’s body — so it’s important to know if you have one before engaging in sexual activity with another person. In order to prevent STIs, understand your risks, get tested regularly, seek treatment immediately (many are curable), and use condoms or other barrier methods during sex.

If left untreated, STIs can cause lifelong health problems. For example, HPV can cause cervical cancer, HIV can lead to AIDS, syphilis can damage your organs and nervous system and gonorrhea and chlamydia can lead to infertility.

How to prevent an STI 

There are a few ways you can prevent contracting an STI:

• Abstaining from sex including vaginal, anal, and oral sex
• Using a barrier method like condoms 
• Limiting your number of sexual partners
• Getting regular testing to prevent the spread and seek treatment when possible
• Getting vaccinated for hepatitis B and HPV

If you have any questions about STIs and/or symptoms that you’re afraid to ask, consider speaking to doctors or nurse practitioners on Maple. They’re available over secure text, audio, or video call 24/7/365 within minutes, and all conversations are secure within the app. Primary care providers on Maple can talk to you about any symptoms you may have, offer advice on safe sex practices or talking to a partner about STI testing, and help you find a place to go for testing.

Keeping up with regular pap tests is a smart move for staying on top of your health. While this test is all about catching cervical cancer early, it’s just one piece of the puzzle. These screenings give you the chance to understand more about what’s going on with your body, helping you make informed decisions about your health. Remember, knowledge is power when it comes to staying healthy.

The information presented here is for educational purposes and is not meant to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulty breathing, for example, please call 911 or go to your nearest emergency room.