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You are here : 3-RX.com > Medical Encyclopedia > Tests and Exams > PAP Smear

PAP Smear

Alternate Names : Pap Test, Papanicolaou Test, Pap Screening

Overview & Description | Preparation & Expectations | Results and Values

A Pap smear is a sampling of cells from a woman's cervix. The cervix is the opening between the vagina and the uterus. The cells are scraped from the cervix during a pelvic exam.

Cervical dysplasia is a condition in which a woman has abnormal changes in the top layer of cells of her cervix. These changes are an early sign that cervical cancer may develop.

A cervical cell goes through precancerous stages for months to years before becoming an invasive, malignant, carcinoma. Catching the disease at the precancerous stage can prevent the development of cervical cancer. Since the Pap smear was introduced 60 years ago, deaths from cancer of the cervix have decreased by 70%.

Who is a candidate for the test?

The American Cancer Society recommends that women have yearly Pap smears beginning at age 18 or when they become sexually active. If a woman has had three negative annual Pap tests in a row, the doctor may recommend less frequent testing. Some women may need more frequent screenings if they are at high risk for cancer of the cervix. Risk factors include the following:

  • becoming sexually active before age 18
  • being the daughter of a woman who took diethylstilbestrol, also known as DES, during pregnancy
  • having a sexual partner who has or has had cancer of the penis
  • having a sexual partner whose previous partner had cancer of the cervix or cervical dysplasia
  • having a weakened immune system, for example, due to HIV or other immunodeficiency disorder
  • having had a sexually transmitted disease, such as chlamydia or human papilloma virus, both of which are strongly linked with cancer of the cervix
  • having had an abnormal Pap smear
  • having had cancer of the vagina or vulva
  • having had more than three sexual partners
  • a history of cancer of the cervix in a woman's sister or mother
  • not using condoms with new sexual partners
  • smoking
  • How is the test performed?

    The first step is for the healthcare provider to perform a pelvic exam. A speculum is a metal or plastic instrument that is placed in the vagina. This instrument allows the provider to see the interior of the vagina and the cervix. A small, sterile brush is used to take a sample of cells from the internal opening of the cervix. A small wooden spatula is used to scrape the outside of the cervix. These two scrapings are placed on a glass slide or in a small bottle filled with a special liquid. The cells are analyzed later under a microscope in a laboratory.


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    PAP Smear: Preparation & Expectations

    Author: David T. Moran, MD
    Reviewer: Melinda Murray Ratini, DO
    Date Reviewed: 08/15/02

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