Pap smear

What is a Pap smear?

A Pap smear is a test that checks for changes in the cells of the cervix. The cervix is the lower part of the uterus that opens into the vagina. Other terms for Pap smear are Papanicolaou smear, Pap test, and cervical smear. The main purpose of the Pap test is to find abnormal cell changes that may arise from cervical cancer or before cancer develops.

What is a pelvic exam?

In a pelvic exam, the uterus, vagina, ovaries, fallopian tubes, bladder and rectum are felt to find any abnormality in their shape or size. During a pelvic exam, an instrument called a speculum is used to widen the vagina so that the upper portion of the vagina and the cervix can be seen.

Why is a Pap smear important?

A Pap smear and pelvic exam are important parts of a woman’s routine health care because they can detect abnormalities that may lead to invasive cancer of the cervix. These abnormalities can be treated before cancer develops. Also, as with many types of cancer, cancer of the cervix is more likely to be treated successfully if it is detected early. The Pap smear tests for abnormal changes in the cervical cells. A precancerous change in the cells, called cervical dysplasia, can be detected by a Pap smear. The abnormal cells can develop into cancer if the dysplasia is not discovered and treated. The Pap smear may also detect viral infections of the cervix, such as genital warts and herpes. It may detect vaginal infections such as infections with yeast or trichomonas. Sometimes the Pap smear can give information about the hormones, especially progesterone and estrogen. Most women should get a Pap smear at least every year, especially if they are sexually active.

You are at an increased risk for cervical cancer if:

• You have had an abnormal Pap smear.
  
• You began to have sexual intercourse in your teens or earlier.
  
• You have a history of many sexual partners.
  
• You or your sexual partner has had genital wart virus infection.
  
• You have had vulvar or vaginal cancer.
  
• Your sexual partner has or had cancer of the penis.
  
• You smoke cigarettes.
  
• Your immune system is weakened; for example, because you have had a transplant, you are taking immunosuppressive drugs, or you have AIDS.

How to prepare for a Pap smear?

Do not use vaginal creams during the 2 days before the test. Do not have intercourse within 24 hours before the Pap smear because it can cause inaccurate test results. You should get this test done when you are not menstruating; the best time is between 10 and 20 days after the first day of the last menstrual period.

How is a Pap test done?

A Pap test is simple, quick, and painless; it can be done in a doctor’s office, a clinic, or a hospital. While a woman lies on an exam table, the clinician inserts a speculum into her vagina to widen it. A sample of cells is taken from the cervix with a wooden scraper and/or a small cervical brush. The specimen (or smear) is placed on a glass slide and preserved with a fixative, or is rinsed in a vial of fixative, and is sent to a laboratory for examination.

What happens after the procedure?

If the cells look normal, no treatment is necessary. The Pap test may show that you have an infection. The doctor may treat you for the infection and suggest that you have another Pap test in several months. If the cells look abnormal, more tests may be necessary. Discuss with the doctor when you should return for any tests or a follow-up exam. A Pap test is not 100% accurate. There are newer methods used now for Pap testing, including computer-assisted testing, which are more accurate. However, these newer methods cost more.