PAP Smear
Alternate Names : Pap Test, Papanicolaou Test, Pap Screening
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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