Your first Pap test: When, why and how
12/4/2025 by Marcie Billings, M.D.
One of the many changes in early adulthood is navigating your medical care on your own. As a female in your early 20s, there are several preventive services important to your overall health and well-being.
Some of these preventive services are:
- Keeping your immunizations up to date, including the HPV and yearly influenza vaccinations.
- Monitoring your blood pressure and body mass index every two years.
- Lipid screening.
- Sexually transmitted infections screening if you're sexually active.
- Cervical cancer screening.
When is cervical cancer screening recommended?
Cervical cancer screening is recommended starting at age 21, regardless of your sexual history or HPV vaccination status. Screening before you turn 21 isn't recommended, unless your immune system is compromised by an HIV infection, chronic immunosuppressant medication or an organ transplant. In your 20s, you should be screened for cervical cancer every three years.
Why is cervical cancer screening recommended?
Worldwide, cervical cancer is the fourth most common cancer in women. It is most often caused by HPV, which is the most common sexually transmitted infection, and at least 80% of sexually active people will be exposed to this virus in their lifetime.
Two things can help prevent HPV-associated cervical cancer:
- HPV vaccination.
- Early detection with a Pap test.
You can be vaccinated for HPV as early as age 9, but you also can get the vaccination at any time until you're 26. The HPV vaccine is highly effective and has minimal side effects.
How does a Pap test work?
A Pap test detects abnormal cervical cells before they cause cancer. It can also detect cells that are already cancerous. It's performed during a pelvic exam.
Here's what to expect:
- An instrument called a speculum is inserted into your vagina, which allows the clinician to see the cervix and scrape some cells off with a brush and spatula, or a combination of the two.
- The lab reviews these cells. The technician looks for changes that may be seen with abnormal cells, precancer or cancer of the cervix.
- A Pap test takes only a few minutes and can be associated with mild discomfort and spotting.
As a young woman, you have endless opportunities. Staying healthy and keeping on track with your healthcare are among your top priorities for living the best life possible.
Marcie Billings, M.D., is chair of the Division of Community Pediatric and Adolescent Medicine (CPAM) and a member of Primary Care in Rochester and Kasson. Her primary areas of practice and special interest are pediatric and adolescent care and medicine.