What is a Pap Smear?
A pap smear is a screening procedure used to test for cancerous or precancerous cells on the cervix. Often, the pap smear is also testing for a virus called “human papilloma virus” or HPV. The cervix is the opening of the uterus. Pap smears do not specifically test for other gynecological problems, or sexually transmitted diseases, but the exam will help identify the presence of abnormal cells, which can indicate further testing.
When Should I have a Pap Smear?
It is recommended that all women get a pap smear done at age 21, regardless of sexual activity. Recommendations on the frequency of recommended pap testing have evolved over recent years. Your own personal history combined with your gynecologist’s opinion will dictate pap smear frequency and whether or not you need the test yearly. It is important to note that patients are encouraged to get an annual exam with their gynecologist regardless of pap smear schedule.
How is a Pap Smear Done?
Typically done in conjunction with a pelvic exam, your gynecologist will have you lie on your back on the exam table with your legs relaxed outward and your feet resting on supports called stirrups. A device called a speculum will be gently inserted into the vagina. The speculum is used to keep the vaginal walls open to provide access to the cervix. A small brush called a cytobrush is used to collect the cervical cell sample. The cervical cell sample is sent to the lab to be tested for the presence of abnormal cells.
Does a Pap Smear Hurt?
Pap smears can be a bit uncomfortable, but the procedure is very quick. During the test women report some discomfort during the brushing of the cervix to collect the cervical cell sample. After the test, women may feel mild discomfort, or slight cramping. In some cases, there may be light vaginal bleeding following the procedure. If discomfort or bleeding continues the day after the test, tell your doctor.
What does an Abnormal Pap Smear Mean?
An abnormal pap smear can be the result of a number of things. It is important to remember that an abnormal pap smear does not mean you have cervical cancer. An abnormal pap smear can indicate:
- Human Papilloma Virus (HPV)
- Cervical Dysplasia
- Cervical Cancer
What is HPV?
Once of the most common causes of an abnormal pap smear is the presence of HPV. HPV is one of the most common sexually transmitted diseases that affects both men and women. Up to 90% of women carry this virus on their cervix or genital area and are completely unaware. In many cases, HPV will clear up on its own without treatment and not lead to other health issues. In some cases, it can lead to the development of certain types of cancer.
What is Cervical Dysplasia?
Cervical dysplasia is not cancer, but rather an abnormal change to the cells on the surface of the cervix. If left untreated, it can lead to cervical cancer. If the patient reports mild to low-grade dysplasia your doctor may choose to monitor with follow-up exams. For more advanced stages of cervical dysplasia, you doctor may recommend removing the cells.
What is Cervical Cancer?
Cervical cancer is typically diagnosed through an abnormal pap smear test. Cervical cancer starts in the cells lining the cervix – the lower part of the uterus. Cervical cancer is a slow-growing cancer. As long as patients have routine pap smears to test for abnormal or precancerous cells, your doctor can remove them before they develop further.
What to do After Abnormal Pap Smear?
Many pap smear abnormalities go away by themselves. In these cases, patients will be asked to return for a repeat pap smear in three to six months. Your gynecologist may recommend further testing. Follow-up testing will depend on the patients age and severity of the abnormality on the pap smear. Follow-up testing may include:
- Repeat pap smear test
- Biopsy or endocervical curettage
To protect your health, follow your doctor’s recommendations regarding how often to get a pap smear and attend to any follow-up tests or treatments that your doctor may recommend.
What is Colposcopy?
Colposcopy is a procedure in which your doctor will look through a microscope at the cervix magnified. Several dyes will be placed on the cervix with cotton swabs, and your doctor will be able to see abnormal areas highlighted. Those changes to the cervix may then be biopsied to get a more accurate assessment of the severity of the abnormality.