Gynecology

The Pap Test

You hear the term all the time... and mostly you don't think much about it unless you get the dreaded call saying that your pap test is abnormal... but do you know the facts about pap tests?

For example, even if your Pap test shows abnormal cells, it doesn't necessarily mean you have cancer. In fact, about one in ten Pap test results show some kind of abnormality. In addition to cancer, reasons for abnormal results include inflammation, infection, hormonal changes and the presence of pre-cancerous cells.

What is a Pap Test?

The Pap test is a simple, relatively painless and inexpensive method for detecting precancerous and cancerous conditions of the cervix (the lower end of the uterus). The test is involves a microscopic examination of the cells scraped from the cervix. It's considered by many to be the best cancer-screening tool available.

Why have one?

The Pap test is used to detect abnormal changes in the cells of the cervix, including bacterial, yeast or viral infections of the cervix (such as herpes simplex) and pre-cancerous or cancerous cells. When pre-cancerous changes in cells in the cervix are identified, you can be treated before the cells have a chance to develop into cancer.

How is a Pap Smear performed?

You will be asked to lie on your back on the examination table with your buttocks at the edge of the table and your feet supported in stirrups. Your doctor will place a metal or plastic instrument called a speculum into your vagina to expand the walls so the cervix can be seen. (Insertion of the speculum may cause slight discomfort. You should let your doctor know if you are too uncomfortable.) Your doctor will then collect cells from around the opening of the cervix and its inner and outer surfaces using a cervical brush. The cells are then smeared onto a glass slide (hence the name Pap "smear") and preserved with a chemical solution to prevent them from drying and changing appearance.

After obtaining the Pap smear, your doctor will conduct a manual examination of your uterus. By placing the fingers of one hand on your abdomen and gently pushing the uterus up with two fingers placed within the vagina, your doctor will check for abnormalities.

How is the Pap Test evaluated?

The slide, along with some personal information (your age and gynecologic and obstetric history), is sent to a laboratory. A specially trained laboratory technologist examines the slide under a microscope and searches for abnormalities among the 50,000 to 300,000 cells found on the slide.

The evaluation consists of three parts:

  1. A statement on the adequacy of the specimen
  2. A general categorization (normal or other)
  3. A descriptive diagnosis—if designated as "other", the sample is evaluated further.

How often should I have a Pap Test?

You should have your first Pap test when you turn 18 or when you become sexually active. Since no test is 100% accurate, it's very important for women to have regular Pap tests—annually for most women and more often if you have a family or personal history of problems. Over time, repeat tests with normal results make it highly unlikely that a problem has been missed.

How can I improve the accuracy of my Pap Test?

  • Don't douche or use vaginal medications, lubricants or contraceptive products, such as spermicides, for 2 to 3 days prior to the test because you may wash away or hide abnormal cells.
  • Try to schedule your Pap test so it takes place between the 12th and 16th days of your menstrual cycle.
  • Abstain from sexual intercourse for 1 to 2 days prior to the test.