Also known as a Pap test and named after its developer, George Papanicolaou, M.D, a Pap smear is a procedure checks for abnormal cells on the cervix. The cervix is the lower part of the uterus that opens at the top of the vagina. Pap tests are extremely important to the early detection of abnormal cells that become cancerous.
To acquire the cell sample, the doctor will use a special instrument called a speculum to hold open the vaginal walls. This tool (pictured below) resembles a duckbill and is used to dilate the vagina so that the cervix is easily accessible. The doctor will then gently brush the cervix with a cotton swab to remove a few cells. This sample of cells is put on a glass slide and sent to a laboratory to be tested. The swabbing is not painful because the cervix has few nerve endings. However, discomfort levels can differ depending on the anatomy of the patient, skill of the practitioner, and other factors. Most people tend to experience a mildly uncomfortable sensation, but this is completely normal. Although the name 'Pap smear' may be daunting, the actual procedure is very quick and easy, so there is no reason to worry!
Females should begin getting routine Pap smears within three years of becoming sexually active or by the age of 21. Females between the ages of 21-65 should get Pap smears about every three years or more frequently if recommended by their healthcare practitioner.1 Regular Pap tests can increase the probability of catching cancerous cells early so that treatment can begin as soon as possible. It is important for females who have already undergone menopause to continue to get Pap smears because they are still at risk of developing cervical cancer. However, screening may be discontinued for females ages 65 to 70 if they have had at least three consecutive normal Pap smears and have not received abnormal results within the past 10 years.2 Pap smears are not foolproof, so regular testing increases the probability of discovering cancer early.
In order to get the most accurate results, take the following into account when scheduling your Pap smear appointment.
- Do not insert anything into the vagina for 24 to 48 hours prior to the Pap smear. This includes intercourse, douches, and any vaginal inserts. Inform your doctor before the appointment if you have recently performed any of these activities.
- Try to avoid scheduling a Pap smear during your period. Menstrual fluid may interfere with the accuracy of your results.
- If you have had previous abnormal Pap smear results, inform your doctor. If you have copies of previous abnormal test results, be sure to bring them to your appointment.
- Schedule a follow-up appointment if you receive abnormal Pap smear results.3, 5
Once the cell sample has made its way to the laboratory, it is checked for abnormalties. Cells go through a series of changes before becoming cancerous, and these changes can occur up to 15 years before the actual cancer develops. The cells will be checked for these changes. It usually takes about 3 weeks to obtain the results from a Pap test.
A negative Pap smear means that your results are completely normal. A positive Pap smear, however, means that your results are not. About 5% to 7% of Pap smears produce abnormal results. Most of the time, abnormal Pap test results do not mean that you have cervical cancer.
If the Pap smear produces abnormal results, further tests are usually performed before a formal diagnosis is made. One of these tests is a colposcopy examination. During a colposcopy, the doctor uses a speculum to hold open the vaginal walls and then uses a magnifying device (called a colposcope) to examine the vagina and cervix for problems.4 If the colposcopy is inconclusive, the doctor will generally perform a cervical biopsy. During this procedure, the doctor takes samples from abnormal tissues in the cervix.6 If the cervical biopsy is also inconclusive, the doctor may perform a cervical conization, in which a cone-shaped portion of the cervix is removed for microscopic analysis.4
Causes of Cervical Cancer
Most cervical cancer is caused by certain types of the human papillomavirus (HPV). HPV is transmitted through sexual contact with an infected person. Not all types of HPV cause cervical cancer, and many types of HPV are asymptomatic. If transmitted, the virus can cause abnormal cells to appear on the cervix. Sometimes, the virus goes away on its own. However, if these cells are not discovered early they also have the potential to turn into cervical cancer. Any female who participates in any kind of sexual activity is vulnerable to the virus. The use of a male or female condom can provide some protection against HPV.1
Regular Pap tests are important for the early detection of abnormal cells that can develop into cervical cancer if left untreated. If detected early enough, cervical cancer can be cured. Besides getting regular screenings, consistently and correctly using condoms and not smoking can greatly decrease your risk of developing cervical cancer.1
1. "Pap Tests & HPV Tests :: Planned Parenthood." Pap Tests & HPV Tests :: Planned Parenthood. N.p., 2014. Web. 16 Aug. 2014. <http://www.plannedparenthood.org/health-info/womens-health/pap-tests-hpv....
2. "Pap Smear After Menopause: How Often to Get a Pap Smear and More." WebMD. WebMD, 2012. Web. 16 Aug. 2014. <http://www.webmd.com/menopause/guide/menopause-pap-smear>.
3. "Colposcopy and Cervical Biopsy: Results, Procedure, & More." WebMD. WebMD, 22 Oct. 2012. Web. 16 Aug. 2014. <http://www.webmd.com/cancer/cervical-cancer/colposcopy-and-cervical-biopsy>.
4. "Pap Test Procedure, Test Results, What Abnormal Results Mean, and More." WebMD. WebMD, 25 June 2012. Web. 16 Aug. 2014. <http://www.webmd.com/women/guide/pap-smear?page=2>.
5. "6 Common Pap Smear Mistakes That Women Make." About.com Cancer. N.p., 2 June 2014. Web. 16 Aug. 2014. <http://cancer.about.com/od/screeninganddiagnosis/tp/papsmearmistake.htm>.
6. "Cone Biopsy (Conization) for Abnormal Cervical Cell Changes." WebMD. WebMD, 12 Dec. 2012. Web. 16 Aug. 2014. <http://www.webmd.com/cancer/cervical-cancer/cone-biopsy-conization-for-a....
Last Updated 16 August 2014.