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What is a Pap Smear?

A Pap smear is a screening test for cervical cancer. The Pap smear was introduced after World War II, and has decreased the incidence of cervical cancer by 50%. The cervix is the mouth or opening of the womb. Cervical cancer is the sixth most common type of female cancer in the United States.

A Pap smear is performed during a woman’s annual physical examination. It involves looking in the vagina to see the cervix, and collecting a sample of the cells from the cervix. Although the exam may be uncomfortable for some women, a Pap smear is a painless procedure.

What if I have an abnormal Pap smear?

Most women who have an abnormal Pap smear do not have cancer. Most abnormal Pap smears are due to changes on the cervix or pre-cancerous cells termed dysplasia. If a woman’s Pap smear is abnormal, the physician may recommend further evaluation to rule out cervical cancer. This consists of a procedure called a colposcopy where the physician looks very closely at the cervix through a lighted microscope device called a colposcope. During this procedure, the physician may take biopsies or scrapings of the cervix or cervical canal to determine the degree of abnormality.

If pre-cancerous cells are discovered, the physician may recommend further follow-up Pap smears or the physician may recommend procedures to get rid of the abnormal cells, such as cryotherapy, laser therapy, or excising (removal of) the abnormal areas. At any point, if a cancerous condition is diagnosed, the patient may be referred to a cancer specialist.

When should I get a Pap smear?
A woman should begin having annual Pap smears at the age of 18 years, or when sexual activity begins. The American College of Obstetricians and Gynecologists suggest that annual screening was appropriate for most American women. If a woman has had three normal Pap smears in a row, and fits into a low risk category, the screening can be less often at the discretion of her physician.

Pap smears can be safely performed during pregnancy and are part of standard prenatal care.

Pap smears are considered a reliable, easy, and inexpensive screening test for cervical cancer, but as with all medical tests, may not pick up every case of cancer or pre-cancerous conditions. The Pap smear was designed to screen for cervical cancer, but occasionally, an abnormality on a Pap smear may mean a cancerous condition of the uterus, fallopian tubes, or even ovaries.

Risk factors for abnormal Pap smears.
Risk factors for abnormal Pap smears, cervical dysplasia and cervical cancer include:
     Early onset sexual activity, 
     Multiple sexual partners, 
     Exposure to the human papilloma virus, and 
     Smoking.

Women who have had a hysterectomy, especially for pre-cancerous conditions of the cervix, cervical cancer, or endometrial cancer should continue to have periodic Pap smears. Women who have had hysterectomies for other benign conditions may continue to have Pap smears at their yearly examination at the physician’s discretion.

Women’s Cancer Network www.wcn.org