What is a Pap Smear?
A pap smear is a test pioneered by Dr. George Papanicolaou to detect cervical cancer or changes in the cervical cells that suggest that cancer may develop in the future. It is a simple procedure in which cells are gently taken from the surface of the cervix and sent to a laboratory where they are examined under a microscope. The results are usually reported in one to two weeks. The test is often done as part of a general evaluation of reproductive health.
What's the big deal?
The cervix is the lowest part of the uterus (womb) connecting it to the vagina. The cervix can be seen and sampled during a routine pelvic exam. Cervical cancer occurs when cells on the surface of the cervix grow out of control and potentially invade deeper into the tissue or spread to other parts of the body. Last year approximately 9.700 cases of invasive cervical cancer were diagnosed. There were 3,700 deaths.
The number of cervical cancer deaths has decreased by over 75% since the pap smear was introduced. Most of the remaining deaths could be prevented if all segments of the population had access to the screening test and medical care.
Cervical cancer usually does not develop suddenly, but instead normal cells develop pre-cancerous changes that can eventually become cancerous. This slow progression provides time to intervene during the pre-cancerous and early stages of cancer when cure rates are high.
In order to find and treat those changes you have to look!
Who needs a pap smear?
All women should begin having pap smears about three years after first intercourse or by age 21. They should be done every 1-2 years. Factors that increase your risk of cervical abnormalities are:
- Infection with HPV (Human Papilloma Virus)
- multiple partners
- a partner that has had multiple partners
- having sex before age 18
- a family history of cervical cancer
- tobacco use
How do I prepare?
The best time to have a pap smear is during the middle of your menstrual cycle. If done too close to your last period blood can obscure the cells and an adequate examination may not be possible. Douching, lubricants, spermacides, vaginal medications, tampon use and sexual activity within 48 hours of testing may also interfere with the evaluation.
What is abnormal?
The pap smear doesn't diagnose a disease but instead acts as a screening test to alert your health professional to make further checks. The results are reported using terms such as:
Negative = Normal, no abnormal cells detected
ASCUS (Atypical squamous cells of undetermined significance) = cells that look abnormal but it is not possible to tell if the abnormality is caused by infection, irritation or is pre-cancer. Often a repeat pap smear is recommended in several months.
LSIL and HSIL (Squamous intraepithelial lesions of low or high grade) = probable pre-cancerous changes that are less or more likely to eventually develop into cancer. Further evaluation is necessary.
Carcinoma = cells that appear consistent with cancer making it highly likely that a cancer is present.