Screening uses specialized tests to find potential health issues or conditions before symptoms appear. The earlier cancer is found, the easier it is to treat.  It’s important to get screened using a Pap test regularly because the risk of getting cervical cancer doesn’t decrease with age — getting screened can save your life.

It’s important to begin having regular Pap tests starting at age 25, or 3 years after becoming sexually active, whichever is later. For example:

• If you’re 17 and are already sexually active: You don’t need to start having Pap tests until you’re 25.
• If you’re not sexually active until 25: You don’t need to start having Pap tests until you’re 28.

Remember that being sexually active doesn’t mean only intercourse. It refers to any skin-to-skin contact in the genital area, including touching, oral sex or intercourse with a partner of any sex. Once you start having Pap tests, you should continue having them until you’re at least 69 years old, even after you’ve been through menopause. Some women may feel they don’t need Pap tests. But you should still have regular Pap tests even if:

• You feel healthy and have no symptoms of cervical cancer
• You’re no longer sexually active
• You’ve only had 1 sexual partner
• You’re in a same-sex relationship
• You’ve had the HPV vaccine
• You’ve been through menopause
• You have no family history of cervical cancer
• You’ve had a hysterectomy and still have your cervix*
• You’ve had cervical cancer in the past

*If you’ve had a hysterectomy, speak to your healthcare provider about whether you still need to be screened.

No matter what, if you’ve ever been sexually active, it’s never too late to start having Pap tests.

How often should I have a Pap test?

Unless your healthcare provider tells you otherwise, here are some guidelines:

• After your first Pap test, plan to have a Pap test once every 3 years: Screening every year gives very little extra protection compared to having a Pap test every 3 years. Having Pap tests too often can lead to diagnosis of cell changes in the cervix that would likely go away on their own. This results in follow-up testing that isn’t needed.
• After age 70, you can stop having Pap tests if:
  • Your last 3 tests, done within the past 10 years, were normal
  • You haven’t had any serious abnormal cell changes in the past
  • You had an HPV reflex test result that was negative

If you experience any changes between Pap tests, such as bleeding between periods, after sexual intercourse or after menopause, tell your healthcare provider right away.

Do I Really Need a Pap Test [brochure]

A Pap test is the main screening test for cervical cancer in Alberta. A Pap test (or what some used to call Pap smears) checks the cells of your cervix, to make sure there are no abnormal cells. Abnormal cells can change over time and become cancerous without pain or symptoms. It’s a quick test done in your healthcare provider’s office or at a women’s health clinic. A sample of cells is taken from your cervix and sent to the lab. The lab checks the sample for any abnormal cells that may lead to cancer. A Pap test doesn’t test for other cancers or sexually transmitted infections such as chlamydia, gonorrhea or human immunodeficiency virus (HIV).

Pap tests only take a few minutes and are done right in your healthcare provider’s office or at a women’s health clinic.

How should I prepare for a Pap test?

Before your Pap test, here are a few things to keep in mind:

• Try to make your appointment for a day when you won’t have your period. If you have any abnormal bleeding, make an appointment with your healthcare provider right away.
• Don’t douche or use contraceptive creams or jellies in the 24 hours before the test.
• Don’t have sexual intercourse in the 24 hours before the test.
• Avoid using personal lubricants in the 48 hours before the test.

How is a Pap test is done?

You’ll be given a gown or sheet and asked to undress from the waist down. Typically you’ll be asked to lie on your back on an examination table and put your feet up on stirrups or to bend your knees. Your healthcare provider will then gently insert an instrument, called a speculum, into your vagina so that the cervix can be seen. A small spatula or brush will then be used to collect a sample of cells from your cervix to send to the lab. While you may feel a little discomfort, it shouldn’t be painful. It may help to take a few deep breaths to relax and reduce tension in your body. Your sample will then be sent to the lab to be examined.

Your Pap test results will be sent directly to your healthcare provider and you’ll receive a result letter by mail from the Alberta Cervical Cancer Screening Program in Alberta Health Services. It’s normal to feel a little nervous or unsure about having a Pap test.  Talking to your healthcare provider first may help to put you at ease.

Watch this short video to learn more about what to expect during a Pap test (Credit:  BC Cancer Agency) 

As with any procedure, there are both benefits and risks; you might think of these as pros and cons. It’s important to be aware of them before having any test so that you can make an informed decision. While no screening test is 100% accurate, scientific evidence shows that having regular Pap tests lowers your risk of dying from cervical cancer.

Benefits of getting a Pap test

• Regular Pap tests check for cervical cell changes, which can be followed closely to make sure they clear up.
• 90% of cervical cancer can be prevented with early treatment.
• If abnormal cells are found, they can be treated early, which may mean less treatment and less time spent recovering.
• The earlier cervical cancer is found, the better your chance of survival.

Risks of getting a Pap test

Pap tests are generally very safe. However, as with any procedure, there are some risks.

• There’s a chance the Pap test can miss abnormal cell changes, even when they’re present (false negative).
• There’s a chance the Pap test can suggest abnormal cell changes, even when there are none (false positive).
• When abnormal cell changes are found, some women may receive more tests or treatment even though the cell changes may never have developed into cancer.

Given how important it is to find cancer early, the benefits of having a Pap test outweigh the risks. However, it’s your decision. It’s always best to talk to your healthcare provider if you have any questions or concerns about the benefits and risks of Pap tests.

All you have to do is make an appointment to have a Pap test at your healthcare provider’s or at a women’s health clinic. If needed, you can visit Where to Get Screened to find a location close to you to have a Pap test.

We’re keeping up with the latest research about cancer screening for 2SLGBTQI+people. We’ll be regularly updating this section with input from our 2SLGBTQI+ partners and emerging evidence.
Last updated December 2023.

Screening Programs is pleased to share three new information sheets on cancer screening that have been designed for the 2SLGBTQI+ community.

Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 
Breast/Chest Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 
Cervical Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 

Words are Important  
We recognize that many gender diverse people may use different words for their body parts. We use the biological terms as a practice, but patients have the right to request that their healthcare providers use different words for their safety and comfort.

Should I get screened? 
A Pap test checks the cervix for any abnormal cell changes. People of any gender identity or sexual orientation who have a cervix and have had sexual contact should consider their need for Pap tests.

• Sexual contact includes any skin-to-skin contact in the genital area, including touching, oral sex or intercourse with a partner of any sex, or genital contact with shared sex toys.

When are Pap tests recommended? 

Consider getting regular Pap tests if you’re between 25 and 69 years old, have a cervix, and have had sexual contact with anyone of any gender. Including if: 

• You had bottom surgery to create a cervix. There’s a small risk that cancer can develop in the tissues of your neo-vagina or neo-cervix.
• You had a hysterectomy, but your cervix wasn’t removed.
• You’re taking testosterone and still have a cervix. Testosterone can sometimes cause changes in the cells of your cervix that look like pre-cancerous cells. It’s important to tell your healthcare provider and the lab because testosterone can affect your Pap test results

Some things to consider: 
You may be at a higher risk of cervical cancer if you have a history of human papillomavirus (HPV) infections or have a condition that weakens your immune system, like HIV.

Plan to have a Pap test once every 3 years. Start at age 25 (or 3 years after your first sexual contact, whichever is later), unless your healthcare provider tells you otherwise.

When are Pap tests not recommended? 

Pap tests are not recommended if: 

• You’re younger than 25 years old
• You haven’t had sex or sexual contact, or it’s been less than 3 years since your first sexual contact
• You don’t have a cervix
• You had a complete hysterectomy including your cervix removed
  ° You may still need regular testing if you have a personal history of abnormal Pap tests. Like a Pap test, a sample of cells is taken from your vaginal vault

It’s important to have Pap tests regularly, even if: 

• You’ve only had 1 sexual partner
• You’ve had the HPV vaccine
• You’ve been through menopause
• You’re no longer sexually active
• You’re a lesbian, bisexual, or queer woman
• You feel healthy and have no symptoms of cervical cancer
• Visit screeningforlife.ca/cervical to learn more

*********
Screening can be worrying for some people due to previous trauma, gender dysphoria, or a lack of trust in healthcare settings. It can be difficult to make cervical screening a priority, especially if you’re concerned about experiencing discrimination. All patients have the right to receive healthcare without discrimination. Talk to your healthcare provider about your personal screening needs and ways to make screening more comfortable for you.

How can I get screened?  
Your healthcare provider can do your Pap test in their clinic or refer you to a provider of your choice.
If you need a healthcare provider:
• Visit albertafindadoctor.ca 
• Call Health Link at 8-1-1
• Visit search.cpsa.ca
(College of Physicians & Surgeons of Alberta)

Gender affirming clinics and providers: 

• DX Medical Centres – Medical Clinic in Edmonton 
• Wellness Centre in Edmonton
• Dr. Jillian DeMontigny (Haig West Family Health Care Clinic in Lethbridge)
• Justik Medical Clinic – Family Medicine Clinic in Edmonton 
• Dr. Ted Jablonski and others (Pinnacle Medical Centres in Calgary and surrounding area)
• Skipping Stone 
• Telus Virtual Health (province-wide) 
• The Alex in Calgary
• The Pride Centre in Edmonton 
• Trans Wellness Initiative (province-wide) 

Gender affirming clinics and providers – Indigenous:  

• Elbow River Healing Lodge in Calgary
• Indigenous Wellness Clinic in Edmonton 
• Dr James Makokis (South Common Medical Clinic in Edmonton)

*Please note, some clinics may not be accepting patients at this time. Contact the clinic directly to find out if they are accepting patients, have a waiting list, or can provide a referral.

Why am I included in the program?  
In Alberta, individuals are included in population-based screening based on their age and the sex marker on their Alberta ID card.

How can I opt out of the Program?  
There are two ways that individuals can opt out of the program:
1. Call Screening Programs at 1-866-727-3926. You will need to provide your personal health care number, name, and date of birth.
2. Change the sex marker on you Alberta ID card to match your gender identity and expression.
a. Information on how to do this can be found at https://www.alberta.ca/birth-record-sex-amendment. 
b. For help with this process, you can make an appointment with one of the Trans ID Clinics listed below:
Calgary: Skipping Stone
Web: https://www.skippingstone.ca/id-clinics
Tel: (587) 333-4342
Email: info@skippingstone.ca 
Edmonton: Student Legal Services of Edmonton
Web: https://www.slsedmonton.com/trans-id-project  
Tel: (780) 492-8287
Email: slsoed@ualberta.ca  

People of any gender identity or sexual orientation may need to get screened for cancer. It is recommended to speak with your healthcare provider about your personal cancer risk level and whether screening is right for you.

For More Information

Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 
Breast/Chest Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 
Cervical Cancer Screening for the 2SLGBTQI+ Community
Download [info sheet] 
LGBTQ2S+/Sexual and Gender Diversity, Alberta Health Services 
Sexual and Reproductive Health, Alberta Health Services

For 24/7 nurse advice or general health information, call Health Link at ​811​.