Pap smear or Papanicolaou test is for the prevention, screening, and early detection of cervical cancer. Abnormal Pap smear result may indicate cervical cancer.

The Pap Smear Test

Why should I have a pap smear?

The only way to know about cervical changes is to do a Pap test. A Pap test can find cervical problems early, when they are easier to treat.

How Pap test is done?

Pap test is a procedure to collect cells from cervix and read under microscope.

First cervix is exposed; with help of spatula, cells from ectocervix are scrapped. Then a small brush or a cotton tipped swab is inserted into the opening of cervix and endocervical cells are scraped.

How often should I get tested?

All women should begin cervical cancer testing (screening) at age 21. Women aged 21 to 29, should have a Pap test every 3 years. HPV testing should not be used for screening in this age group (it may be used as a part of follow-up for an abnormal Pap test).

Another option for women 30 to 65 is to get tested every 3 years with just the Pap test.

Women who are at high risk of cervical cancer because of a suppressed immune system (for example from HIV infection, organ transplant, long-term steroid use) or exposed to DES may need to be screened more often.

Women who have had a total hysterectomy (removal of the uterus and cervix) should stop screening unless the hysterectomy was done as a treatment for cervical pre-cancer or cancer. Women who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening accordingly.

Although annual (every year) screening should not be done, women who have abnormal screening results may need to have a follow-up Pap test done in 6 months or a year.

What are risk factors for cervical cancer?

  1. HPV infection
  2. Smoking.
  3. Weakened immune system.
  4. Chlamydia infection.
  5. Being overweight.
  6. Long term use of oral contraceptives.
  7. IUD use.
  8. Multiple full-term pregnancies.
  9. Being younger than 17 at first full term pregnancy.
  10. Low economic status.
  11. Hormonal therapy.

What cells are read and studied under microscope?

  • The part of the cervix closest to the body of the uterus is called the endocervix and is covered with glandular cells.
  • The part next to the vagina is the ectocervix and is covered in squamous cells.
  • These two cell types meet at a place called the transformation zone. The exact location of the transformation zone changes as you age and if you give birth.

Cells in ectocervix and endocervix are read under microscope.

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