Pap Smear
What it is:
A Pap smear is a type of screening for cervical cancer. This test involves scraping cells from the opening of the cervix (the lower part of the uterus that opens at the top of the vagina) so they can be examined under a microscope.
How the test is performed
You lie on a table, place your feet in stirrups and the doctor or nurse gently places an instrument called a speculum into the vagina to open it slightly. This allows the doctor or nurse to see inside the vagina and cervix.
Cells are gently scraped from the cervix area, and the sample of cells is sent to a lab for examination.
How to prepare for the test
Tell your doctor or nurse about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results.
Also tell your doctor or nurse if you:
- Have had an abnormal Pap smear in the past
- Might be pregnant
Do not do the following for 24 hours before the test:
- Douche
- Have intercourse
- Use tampons
Avoid scheduling your Pap smear while you have your period (are menstruating). Blood may make your Pap smear results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your doctor will determine if a Pap smear can still be done. Empty your bladder just before the test.
How the test will feel
A Pap smear may cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may also bleed a little bit after the test.
Why the test is performed
A Pap smear is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap smears. Screening should start at age 21.
After the first test:
You should have a Pap smear every 3 years to check for cervical cancer.
If you are older than 30 and you also have HPV testing done and both the Pap smear and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer).
Most women can stop having Pap smears after age 65 to 70 as long as they have had three negative tests within the past 10 years. You may not need to have a Pap smear if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap smear, cervical cancer or other pelvic cancer. Discuss this with your doctor.
Normal results
A normal result means there are no abnormal cells present. A Pap smear test is not 100% accurate, however, because Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly and follow-up Pap smears should find any changes in time for treatment.
What abnormal results mean
Abnormal results are grouped as follows:
ASCUS or AGUS
This result means there are atypical cells, but it is uncertain or unclear what these changes mean. The changes may be due to HPV, but they may also mean there are changes that may lead to cancer.
LSIL (low-grade dysplasia) or HSIL (high-grade dysplasia)
This means changes that may lead to cancer are present. The risk of cervical cancer is greater with HSIL.
Carcinoma in situ (CIS)
This result most often means the abnormal changes are likely to lead to cervical cancer if not treated.
Atypical squamous cells (ASC)
Abnormal changes have been found and may be HSIL.
Atypical glandular cells (AGC)
Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus.
The next step
When a Pap smear shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of your Pap smear, your previous history of Pap smears and risk factors you may have for cervical cancer. For minor cell changes, doctors will recommend another Pap smear in 6 to 12 months.
Follow-up testing may include:
- Colposcopy-directed biopsy
- An HPV test to check for the presence of the HPV virus types most likely to cause cancer
Source: Penn State Hershey Medical Center
A Pap smear is a type of screening for cervical cancer. This test involves scraping cells from the opening of the cervix (the lower part of the uterus that opens at the top of the vagina) so they can be examined under a microscope.
How the test is performed
You lie on a table, place your feet in stirrups and the doctor or nurse gently places an instrument called a speculum into the vagina to open it slightly. This allows the doctor or nurse to see inside the vagina and cervix.
Cells are gently scraped from the cervix area, and the sample of cells is sent to a lab for examination.
How to prepare for the test
Tell your doctor or nurse about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results.
Also tell your doctor or nurse if you:
- Have had an abnormal Pap smear in the past
- Might be pregnant
Do not do the following for 24 hours before the test:
- Douche
- Have intercourse
- Use tampons
Avoid scheduling your Pap smear while you have your period (are menstruating). Blood may make your Pap smear results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your doctor will determine if a Pap smear can still be done. Empty your bladder just before the test.
How the test will feel
A Pap smear may cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may also bleed a little bit after the test.
Why the test is performed
A Pap smear is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap smears. Screening should start at age 21.
After the first test:
You should have a Pap smear every 3 years to check for cervical cancer.
If you are older than 30 and you also have HPV testing done and both the Pap smear and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer).
Most women can stop having Pap smears after age 65 to 70 as long as they have had three negative tests within the past 10 years. You may not need to have a Pap smear if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap smear, cervical cancer or other pelvic cancer. Discuss this with your doctor.
Normal results
A normal result means there are no abnormal cells present. A Pap smear test is not 100% accurate, however, because Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly and follow-up Pap smears should find any changes in time for treatment.
What abnormal results mean
Abnormal results are grouped as follows:
ASCUS or AGUS
This result means there are atypical cells, but it is uncertain or unclear what these changes mean. The changes may be due to HPV, but they may also mean there are changes that may lead to cancer.
LSIL (low-grade dysplasia) or HSIL (high-grade dysplasia)
This means changes that may lead to cancer are present. The risk of cervical cancer is greater with HSIL.
Carcinoma in situ (CIS)
This result most often means the abnormal changes are likely to lead to cervical cancer if not treated.
Atypical squamous cells (ASC)
Abnormal changes have been found and may be HSIL.
Atypical glandular cells (AGC)
Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus.
The next step
When a Pap smear shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of your Pap smear, your previous history of Pap smears and risk factors you may have for cervical cancer. For minor cell changes, doctors will recommend another Pap smear in 6 to 12 months.
Follow-up testing may include:
- Colposcopy-directed biopsy
- An HPV test to check for the presence of the HPV virus types most likely to cause cancer
Source: Penn State Hershey Medical Center
