Does a Pap Smear Cover STD Testing?

A common misconception I have discovered with many patients is the belief that when a pap smear is done, it includes a check for sexually transmitted diseases (STD). This is NOT the case.  In our office, the pap smear is done soley to rule out abnormal cells on the cervix.  If requested, a check for HPV (human papilloma virus) can be included.  The doctors usually request that HPV be added to any pap smear reading if the results are abnormal. This information aids the doctor in the follow-up of the abnormal pap smear.  Some physicians routinely check for HPV with all pap smears.  Our gynecologists do not do this routinely as it does add an extra cost to the pap smear reading.

Some labs are able to check for STD’s in the pap smear specimen.  We prefer to check STD’s with a culture system called ONE SWAB.  This culture is extremely sensitive, relatively inexpensive and can accurately confirm all STD’s except the HIV infection.  HIV can only be confirmed with a blood test.  One must understand that the ONE SWAB culture will only test for the specific bacteria that the physician orders.  There is not an automatic check for all STD’s.

If you would like to have a culture for STD’s during your exam with us, please discuss your wishes before the exam is done.  After your doctor takes the pap smear specimen, he or she does a bimanual exam to evaluate the uterus, tubes and ovaries.  Lubricating gel is used.  As soon as the gel is introduced into the vagina, we are unable to perform a ONE SWAB culture-the results are affected by the gel. You would have to return for a second exam at least 24 hours later.  To avoid this inconvenience, please discuss your wishes with your doctor before the exam is initiated, including any specific STD that you are concerned with.

In summary, a pap smear is not a check for STD’s.  It is always best to discuss all of your concerns with your doctor at the beginning of the office encounter so that he or she can tailor the exam to best address all of your concerns.