A Pap smear test is a screening test to collect and microscopically examine cells taken from the cervix and cervical canal. The Pap smear is a screening test for cervical cancer. Cells that are scraped from around the opening of the cervix and from the cervical canal are examined under a microscope. The cervix is the lower part of the uterus that opens in the vagina.
How is the Pap smear done?
You lie on a table and spread your legs apart. The doctor gently places an instrument called a speculum into the vagina to open it slightly. This allows the doctor to see the cervix in the vagina. Cells are gently scraped from the cervix area and from the cervical canal. The sample of cells is sent to a lab for examination and analysis.
Avoid scheduling your Pap smear while you have your period. Blood may make the Pap smear results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your doctor will determine if the Pap smear can still be done or not. Empty your bladder just before the test.
A Pap smear may cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may bleed a little bit after the test.
The 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 until age of 65. Most women who are from ages 21 - 65 need regular Pap smear screening.
Interpretation of Pap smear results:
Cervical cancer usually develops slowly. It starts as precancerous abnormal cell changes of the cervix called dysplasia. Those cell changes can be detected by a Pap smear and is nearly 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer didn’t have regular Pap smears, or they did not follow up on abnormal Pap smear results. 90% of all cervical cancers are caused by human papillomavirus (HPV).
A normal result means there are no abnormal cells present. The Pap smear test is not 100% accurate. 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.
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
• 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
When a Pap smear shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the 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.
Abnormal Pap smear
Initial Pap smear results reported as abnormal indicate cell changes of the cervix. After an abnormal Pap smear, your doctor may ask you to repeat Pap smear or a colposcopy to determine the significance of these cell changes. A colposcopy requires use of an instrument called a colposcope, which has a series of lenses that magnify the tissues of the cervix. It is from this instrument that the procedure gets its name.