How the Test is Performed
The Pap smear is done as part of a gynecological exam. You will lie on a table and place your feet in stirrups to position your pelvis for examination. The health care provider will insert an instrument (speculum) into your vagina and open it slightly to see inside the vaginal canal.
The health care provider will take a sample of cells from the outside and just inside the opening of the cervix (cervical canal) by gently scraping the outside of the cervix with a wooden or plastic spatula, then inserting a small brush that looks like a pipe cleaner into the canal.
The cells are placed on a glass slide, or put in a bottle containing a preservative, and then sent to the lab for examination.
How to Prepare for the TestTell your health care provider if you:
- Are taking any medications or birth control pills
- Have had an abnormal Pap smear
- Might be pregnant
- Having intercourse
- Taking a tub bath
- Using tampons
How the Test Will FeelYou may have some discomfort, similar to menstrual cramps, and a feeling of pressure during the procedure. You may bleed a little bit after the test.
Why the Test is PerformedThe Pap smear can detect cancerous or precancerous conditions of the cervix. Most invasive cancers of the cervix can be detected early if women have Pap tests and pelvic examinations.
Screening should start within 3 years after first having vaginal intercourse or by age 21. After the first test:
- Woman should have a Pap smear every 2 years to check for cervical cancer.
- If you are over age 30 or your Pap smears have been negative for 3 times in a row, your doctor may tell you that you only need a Pap smear every 3 years.
- If you or your sexual partner have other new partners, then you should have a Pap smear every 2 years.
- After age 65-70, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.
- If you have a new sexual partner after age 65, you should begin having Pap smear screening again.
Normal ResultsA normal value is negative, meaning there are no abnormal cells present.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results MeanThe current system divides the abnormal results into these main areas:
- ASCUS or AGUS (atypical cells of uncertain significance): These changes may be due to infection with HPV but may also mean there are precancerous changes present.
- LSIL (low-grade dysplasia) or HSIL (high-grade dysplasia): This means precancer changes are likely to be present; the risk of cancer is greater if the result is HSIL.
- Carcinoma in situ (CIS): This usually means the abnormal changes are likely to progress to cancer.
- Atypical squamous cells (ASC–H): This means abnormal changes have been found and may be HSIL.
- Atypical glandular cells (AGC): Cell changes are seen that suggest precancer of the upper part of the cervical canal or inside the uterus.
This may include:
- Colposcopy-directed biopsy
- An HPV test to check for the presence of the HPV virus types most likely to cause cancer
RisksThere are no risks involved.
ConsiderationsThe Pap smear test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Fortunately, cervical cancer develops very slowly in most women and follow-up Pap smears should identify worrisome changes in time for treatment.
The following drugs may affect Pap smears:
- Compounds in cigarettes
- Silver nitrate
Are Pap smears still necessary if I'm 62 years old and have had a hysterectomy?http://www.mayoclinic.com/health/pap-smear/AN00013