What is the Pap test?
A Pap smear, also known as a Pap test, named after its developer, George Papanicolaou, MD, is a process that checks for abnormal cells on the cervix. The cervix is located on the lower part of the uterus, near the end of the vagina. It is very important to do this test before any abnormal cells have a chance to become cancerous. To take the sample, a doctor will hold open the vaginal walls with a special instrument called a speculum. This tool, which is pictured below, resembles the bills of a duck and is used to dilate the vagina, making access to the cervix much easier. The doctor will then gently brush your cervix with a cotton swab to remove a few cells. This sample is put on to a glass slide and sent into a laboratory to be tested. This is not a painful procedure because the cervix has so few nerve endings. However, this can depend on the anatomy of the patient, psychological factors, the skill of the practitioner, and other conditions. Some people tend to experience a mildly uncomfortable sensation, but this is completely normal. Although the name "Pap smear" may be extremely daunting, the actual process is quick and easy, so don't worry!
What do the results mean?
Once the cells have made their way into the laboratory, they are checked for abnormal signs. Cells go through a series of changes before they become cancerous and these changes may occur up to fifteen years before cancer develops. The cells will be checked for these changes. It normally takes about 3 weeks to obtain results for 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 normal. Only about 5% to 7% of Pap smears produce abnormal results. If the results are positive, this may mean one of many things:
- Inflammation: this may be caused by an infection of the cervix, a yeast infection, HPV or herpes virus, etc.
- Dysplasia: a term used to describe the appearance of abnormal cells on the cervix. It can be classified into mild, moderate, and severe. It is considered a precancerous condition and should be monitored.
- Carcinoma in situ: a more serious sign of cancer that affects the top layers of the cervix, but does not travel beyond that.
- Advanced Cancer: the most serious condition
If the Pap smear is abnormal there are a number of treatments, including colposcopy, conization, cryocauterization, lazer therapy, hysterectomy, and large-loop excision (LEEP) of the transformation zone. Normally, if the results show positive, further tests are done before a finalized diagnosis can be made.
How often should I go in for a Pap smear?
After becoming sexually active, women should wait no longer than three years to get a Pap smear. If you are not sexually active, it is important to have a Pap test by the age of 21. Keep having a Pap smear once a year until you have three consecutive positive results. After that, it is recommended that women have a Pap smear every two years, or even more frequently if the doctor recommends it. You can never have too many! It is also important for women who have already undergone menopause to continue to get Pap smears because no matter what their age, women can still be vulnerable to cervical cancer. Pap smears do not always accurately test for cervical cancer, so regular tests increase the probability of discovering cancer early.
What causes cervical cancer?
Cervical cancer (cancer of the cervix) is caused by certain types of the human papillomavirus (HPV). When a woman is infected by the HPV, the virus causes abnormal cells to appear on the cervix. Sometimes the virus goes away on its own, however if these cells are not discovered early they have the potential to turn into cervical cancer. Anyone who participates in any kind of sexual activity is vulnerable to the virus. A number of factors have been linked to cervical cancer including having sexual intercourse early, having multiple sexual partners, smoking tobacco, and even inhaling secondary smoke. It is very easily transmitted, and the only way to protect you completely is to abstain from any kind of sexual activity.
© - Reproduced with permission of SexInfo, University of California at Santa Barbara, 2007.