Pap Smear

What Is a Pap Smear Exam?

A Pap smear (or Pap test) is a medical procedure for detecting cervical cancer in women. The name is derived from Georgios Papanikolaou, one of the procedure’s inventors in the 1920s. A Pap smear involves the collection of cells from the lining of the cervix, an organ in the female reproductive system that links the vagina to the uterus. These cells are then analyzed for evidence of cancer or precancerous abnormalities. Pap smears are a preventive procedure, designed to catch cancer in its early stages, when treatment is most likely to be successful in overcoming the disease.

Pap smears are an effective means of combating cervical cancer, reducing incidence and mortality. To learn more about Pap smears and their associated health benefits, contact a Baptist Health gynecologist.

What Is the Purpose of a Pap Smear Test? When Is it Performed?

The purpose of a Pap smear screening test is to look for evidence of cancer or a precancerous condition in the cervix. It is often combined with a test for the human papillomavirus (HPV) because certain HPV variants are among the leading causes of this type of cancer. Cervical cancer remains a serious health issue for women around the world.

Pap smears are recommended for women according to the following schedule:

Individuals in higher-risk categories may require more frequent testing. Included in this category are women who are:

• HIV-positive or who have a weakened immune system from chemotherapy, an organ transplant, or certain medical conditions
• Age 30 or older with one or more abnormal Pap-smear results
• Age 65 or older, on their physician’s advice

Who Can Consider Stopping Pap Smears?

Although Pap smears are recommended for most of adult life, there are reasons why a person could consider stopping pap smears. It is important to discuss any reason or consideration for stopping Pap smears with your healthcare provider. Reasons for stopping may include:

• Being over the age of 65. If you have never had abnormal findings on any cancer screening and have discussed your health history and risk factors with your doctor, it may be a consideration to stop having Pap smears.
• After having a total hysterectomy. A total hysterectomy involves the removal of the uterus and cervix. If these organs are removed, a Pap smear may be unnecessary. If you have no history of cancer or abnormal findings on cancer screens, it may be considered to stop doing Pap smears.

How Do I Prepare for a Pap Smear Screening?

In the 48 hours prior to your test:

• Abstain from vaginal intercourse
• Avoid vaginal inserts, including tampons and suppositories
• Don’t apply powders, sprays, or lubricants on or near the genitals
• Refrain from douching with water, vinegar, or any other fluids.

Women pregnant for more than 24 weeks should delay having a Pap smear until at least 12 weeks after giving birth.

What Should I Expect During this Procedure?

Pap smears are typically performed at a gynecologist’s office. They involve the following steps:

• You lie on your back on an examination table with your legs spread and your feet in stirrups.
• Your physician inserts a medical device called a speculum into your vagina, which opens the vaginal canal and allows access to the cervix.
• He or she then collects a cell sample from the cervical lining using a spatula, brush, or cytobrush.
• The cells are preserved and sent to a medical lab for evaluation.

A Pap smear can be irritating but is rarely painful. You may experience light bleeding for a day or two afterwards. If the bleeding persists, contact your gynecologist.

What Should I Expect After this Procedure?

You can resume normal activities immediately after a Pap smear. Your sample will be analyzed for evidence of abnormal or cancerous cells. The results of your test will be made available to you in one to three weeks after collection of the cell sample.

Risks of Getting a Pap Smear

Getting a Pap smear is a safe and effective way to screen for cervical cancer. However, Pap smear tests do come with the risk of producing a false-negative. A false-negative finding means that the results show no signs of cancer, when abnormalities or cancer are present in the body. A false-negative may occur when:

• Not enough cells were collected
• Not enough abnormal cells were collected
• Abnormal cells may be concealed by the blood or infection
• Vaginal medicines or douching may have washed away the abnormal cells

What Results Should I Expect from a Pap Smear?

Pap smears have two possible results: normal and abnormal pap smear.

Normal Pap Smear Results

A normal or negative test result indicates that no cancerous or precancerous cells were found in your sample. There is nothing else that you need to do until your next regularly scheduled examination (typically in three or five years, depending on individual circumstances).

Abnormal Pap Test Results

Abnormal or positive results include:

• Atypical squamous cells of undetermined significance (ASCUS): Squamous cells are thin, flat cells growing at the surface of the cervix. ASCUS cells show signs of abnormality but not necessarily enough to be considered precancerous.
• Atypical glandular cells: Glandular cells are mucous-producing cells found in the openings of the cervix and uterus. Atypical cells may prove precancerous but require additional testing.
• Squamous intraepithelial lesion: This term is used for squamous cells that are likely precancerous.
• Squamous cell cancer: Highly abnormal squamous cells indicate the presence of cancer.
• Adenocarcinoma cells: These are cancerous glandular cells.

If abnormal cells are found in your sample, your physician may arrange for a follow-up procedure called a colposcopy.

Learn More about Pap Smears at Baptist Health

For more information about Pap smears, or to schedule an appointment, contact a Baptist Health gynecologist.