Download Pap Testing (What is it and why do I need it?)

Pap Test
A Pap test is a procedure to test for cervical cancer in women. A Pap test involves
collecting cells from your cervix — the lower, narrow end of your uterus that's at the top
of your vagina.
Detecting cervical cancer early with a Pap test gives you a greater chance at a cure. A
Pap test can also detect changes in your cervical cells that suggest cancer may develop
in the future. Detecting these abnormal cells early with a Pap test is your first step in
halting the possible development of cervical cancer.
A Pap test is used to screen for cervical cancer. The Pap test is usually done in conjunction with a pelvic exam. In women
older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually
transmitted infection that can cause cervical cancer in some women.
Who should have a Pap test?
You and your health care provider can decide when it's time for you to begin Pap testing and how often you should have
the test. In general, health care providers recommend beginning Pap testing at age 21 and then every three years if no
abnormal cells are found. After age 30, Pap test are generally recommended every three years, or every five years when
the Pap test is combined with an HPV test.
If you have certain risk factors, your health care provider may recommend more-frequent Pap testing, regardless of your
age. These risk factors include:
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A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
Exposure to diethylstilbestrol (DES) before birth
HIV infection
Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use
Risks of Pap testing
A Pap test is a safe way to screen for cervical cancer. However, a Pap test isn't foolproof. It's possible to receive falsenegative results — meaning that the test indicates no abnormality, even though you do have abnormal cells. A falsenegative result doesn't mean that a mistake was made. Factors that can cause a false-negative result include:
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An inadequate collection of cells
A small number of abnormal cells
Blood or inflammatory cells obscuring the abnormal cells
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Although it's possible for abnormal cells to go undetected, time is on your side. Cervical cancer takes several years to
develop. And if one test doesn't detect the abnormal cells, the next test most likely will.
How to prepare for your Pap test
To ensure that your Pap test is most effective, follow these tips prior to your test:
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Avoid intercourse, douching or using any vaginal medicines or spermicidal foams, creams or jellies for two days
before having a Pap test, as these may wash away or obscure abnormal cells.
Try not to schedule a Pap test during your menstrual period. Although the test can be done, it's best to avoid this
time of your cycle, if possible.
What you can expect
A Pap test is performed in your health care provider's office and takes only a few minutes. You may be asked to undress
completely or only from the waist down.
You'll lie down on your back on an exam table with your knees bent. Your heels rest in supports called stirrups. Your
health care provider 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 provider can easily see your cervix. Inserting the speculum may cause a
sensation of pressure in your pelvic area. Then your healthcare provider will take samples of your cervical cells using a
soft brush.
Your healthcare provider transfers the cell sample collected from your cervix into a container holding a special liquid to
preserve the sample. The samples are transferred to a laboratory where they're examined under a microscope to look
for characteristics in the cells that indicate cancer or a precancerous condition. The Pap test results can alert your doctor
to the presence of suspicious cells that need further testing.
After your Pap test, you can go about your day without restrictions. It is not uncommon to have some minimal bloody
vaginal discharge after the Pap test.
Pap test results
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Normal results - If only normal cervical cells were discovered during your Pap test, you're said to have a
“negative” result. You won't need any further treatment or testing until you're due for your next Pap test and
pelvic exam.
Abnormal results - If abnormal or unusual cells were discovered during your Pap test, you're said to have a
“positive” result. A positive result doesn't mean you have cervical cancer. What a positive result means depends
on the type of cells discovered in your Pap test. There are different types of abnormalities, as described below.
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Here are some terms your health care provider might use to describe a “positive” result and what your next course of
action might be:
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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. More can be learned about the abnormal
cells by testing for the presence of certain types of the human papilloma virus (HPV) which are known to
promote the development of cancer, these are referred to as “high risk HPV”. If none of these 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 may need to have a repeat Pap test sooner. Talk to your healthcare provider regarding their
recommendations for further testing.
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Squamous intraepithelial lesion. This term is used to indicate that the cells collected from the Pap test may be
precancerous. If the changes are low grade, it means 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. Additional diagnostic
testing is necessary.
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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.
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Squamous cell cancer or adenocarcinoma cells. This result means the cells collected for the Pap test appear so
abnormal that the pathologist is almost certain a cancer is present. "Squamous cell cancer" 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 provider will recommend prompt evaluation.
If your Pap test is abnormal, your health care provider may refer you for further testing with a common procedure called
colposcopy. During a colposcopy a special magnifying instrument (colposcope) is used to examine the tissues of the
cervix, vagina and vulva. During this procedure, your health care provider may also take a tissue sample (biopsy) from
any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis.
Further treatment recommendations will be based on these results.
References: Mayo Clinic, American Society for Colposcopy and Cervical Pathology
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