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What Is A Pap Smear?

Written By: Letitia Spencer, MD

A pap smear is a screening test for cervical cancer. Screening tests are examinations done to detect the development of a disease or cancer in its early stages.Often, these tests are done when there are no symptoms of illness. In the case of cervical cancer, the pap smear is used to detect abnormal cells on the cervix that have the potential to turn into cancerous cells.

The pap smear is performed during a regular office visit.Your provider will use a wooden scraper and/or a small brush to collect a sample of cells from the cervix. These cells are placed on a slide and sent to a laboratory to check for abnormalities.

Who Should Have Pap Smears?
All women who are 18 years or older, or who are sexually active should have regular pap smears.Initially your provider will do them every year. Once you have several consecutive pap smears that are normal, your doctor may decrease the frequency to every 2-3 years.

Women who have had an abnormal pap smear in the past may need to have more frequent pap smears. Women who have had a total hysterectomy (uterus and cervix removed) for non-cancerous reasons may not need to have pap smears.   On the other hand, women who have had their uterus and cervix removed because of cancer (or who have risk factors for developing cancer) will need to continue to have pap smears.

How can I prepare for a Pap Smear?

If you know you are going to have a pap smear, you should avoid douching for 48 hours before the test. In addition, you should avoid using vaginal creams one week before the test, and abstain from sexual intercourse for 24 hours in advance.It is best to schedule the pap test for a time when you are not having your menstrual cycle.

What does a Pap Smear tell you?

Once your pap smear is completed, the laboratory will evaluate the cells to determine if they are normal or not. The laboratory uses a system developed by the National Cancer Institute to classify the pap test.This classification helps doctors plan treatment.

  •   Normal:  Only normal cells were seen on your pap test.

  •  Atypical squamous cells of undetermined significance (ASCUS): Abnormal cells were found in the cells of the outer cervix.

  • Atypical glandular cells of undetermined significance (AGUS): Abnormal cells found in the cells lining the inner cervix.

  •  Squamous intraepithelial lesions (SIL): The cervical cells show mild or severe changes that may progress to cancer.

  • Cancer:  The cells show abnormalities consistent with cancer.

I Have An Abnormal Pap Smear, What Can I Expect Next?

If your pap test comes back abnormal, your doctor will ask you to come in for further testing. This may consist of having a repeat pap smear in a few weeks or a few months.

You may be asked to come in for a colposcopy. This is a procedure done in the clinic where the doctor takes biopsies of abnormal areas on the cervix. The abnormal areas are visualized by use of a microscope after applying acetic acid (vinegar) to your cervix.The acetic acid will stain abnormal cells on the cervix which the doctor can then biopsy.

These biopsies are sent to the laboratory for an evaluation, looking for the presence of cancer.Depending on these results, your doctor will either have you return for a repeat pap smear at a later time, or have you come back for more extensive biopsies.

What can I do to help prevent cervical cancer?

Cervical cancer is one of the only types of cancer that is preventable. You should see your doctor annually for a pap smear and exam.   Women who have never had a pap test or who have not had one for several years have a higher-than-average risk of developing cervical cancer.

Other preventable risk factors for developing cervical cancer include multiple sexual partners, HIV infection, HPV infection (genital warts) and smoking.  Condom use will help decrease many of these infectious risk factors from contributing to the development of cervical cancer.


Empowerment Points

A pap smear is a screening test used to detect the early stages of cervical cancer.

You should have a pap smear annually unless your doctor advises otherwise.

Avoid douching, intercourse or the use of vaginal creams before your pap smear.

An abnormal pap smear does not mean you have cancer.

If you have an abnormal pap smear you may need to repeat your pap smear or have biopsies of your cervix taken.

References:

Cancer Net; National Cancer Institute

For Women’s Health: www.4woman.gov