A pap smear, also called a pap test, is a procedure to test for cervical cancer in women. A pap smear involves collecting cells from your cervix the lower, narrow end of your uterus.
Detecting cervical cancer early with a pap smear gives you a greater chance for treatment and curing of cervical cancer. A pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Early detection of these cells is your first step in stopping the possible development of cervical cancer. Furthermore, a pap smear can also detect any infection that you may or may not have. A pap smear can be done in conjunction with a pelvic examination.
You’ll be asked to change out of your clothes and into an examination gown in privacy. This means that you will need to take of your bra and panties as well. Depending on the procedure, if it is only a pap smear or in combination with pelvic examination, your health care practitioner might even ask you just to take off your clothes from the waist downwards.
During the pap smear, you will lie on your back on an examination bed. To allow your health care practitioner to examine you more comfortable, you will have to bend your knees and place your feet on the corners of the bed for support. You’ll be asked to slide your body toward the end of the bed and let your knees fall apart.
To assist your health care practitioner, try to keep your legs as far apart as possible. This will allow your health care practitioner to examine you more thoroughly and this will be less uncomfortable for you.
Your health care practitioner will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of the vagina apart so that your health care practitioner can easily see your cervix. Inserting the speculum may cause sensation of pressure in your pelvic area. The procedure is not painful, but may be uncomfortable due to the cold lubrication and the speculum that is inserted in your vagina.
Then your health care practitioner will take two samples of your cervical cells using a soft brush and/or a flat scraping device called a spatula. This doesn’t hurt and you may not even feel the sample being taken.
The sample is then spread onto two microscope slides and sprayed with fixation spray to keep the cells in place. He/she might also transfer the cells collected into a container containing a special liquid to preserve the sample and this is called a liquid-bases pap smear test
After removal of the speculum, your health care practitioner might perform or continue with a pelvic examination.
After the Pap smear
After your pap smear, you can continue with your day as normal without any restrictions about your day without any restrictions.
The samples are transferred to a laboratory where a cytologist (a person trained to detect abnormal cells) will examine your sample. The cytologist work in cooperation with a pathologist (a doctor who specializes in cellular abnormalities). The pathologist is responsible for the final diagnosis.
Ask your health care practitioner when you can expect the results of your pap smear. In some cases, your health care practitioner will only contact you if something of concern is found or if it’s determined that you need further testing.
Results
Normal results If only normal cervical cells were discovered during your pap smear, your test will then be negative for presence of cancer cells. You won’t need any further treatment or testing until you’re due for your next pap smear and pelvic examination. Abnormal results If abnormal or unusual cells were discovered during your pap smear, this means that you have a positive result or the presence of cancer cells were noted.
Here are some terms your doctor might use and what your next course of action might be:
Atypical squamous cells of undetermined significance (ASCUS). Squamous cells are thin and flat and grow on the surface of a healthy cervix. In the case of ASCUS, the pap smear reveals slightly abnormal squamous cells, but the changes don’t clearly suggest that precancerous cells are present. With the liquid-based test, your health care practitioner can reanalyze the sample to check for the presence of viruses known to promote the development of cancer, such as some types of human papillomavirus (HPV). [see: STI’s > Genital Warts) If no high-risk viruses are present, the abnormal cells found as a result of the test aren’t of great concern. If worrisome viruses are present, you’ll need further testing.
Squamous intraepithelial lesion. This term is used to indicate that the cells collected from the pap smear may be precancerous. If the changes are low-grade, the size, shape and other characteristics of the cells suggest that if a precancerous lesion is present, it’s likely to be years away from becoming a cancer. If the changes are high-grade, there’s a greater chance that the lesion may develop into cancer much sooner. Diagnostic testing is necessary.
Atypical glandular cells. Glandular cells produce mucus and grow in the opening of your cervix and within your uterus. Atypical glandular cells may appear to be slightly abnormal, but it’s unclear whether they’re cancerous. Further testing is needed to determine the source of the abnormal cells and their significance.
Squamous cancer or adenocarcinoma cells. The cells collected from the pap smear appear so abnormal that the pathologist is almost certain a cancer is present in the vagina, cervix or, occasionally, the uterus. Squamous refers to cancers arising in the flat surface cells of the vagina or cervix. Adenocarcinoma refers to cancers arising in glandular cells. If such cells are found, your health care practitioner will recommend additional examinations.
If your pap smear is abnormal, your doctor may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. He or she may take a tissue sample (biopsy) from any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and for a definitive diagnosis.
