When you, as a woman, go to your doctor for a regular checkup, you are usually advised to get a few routine tests, including one to test for cervical cancer. This is called a Pap test, and for the test to be carried out, a medical professional will take something called a Pap smear.
This post will give you an overview of everything you need to know about a Pap smear and how best to prepare for it.
What is a Pap Smear?
The term Pap is short for the name Papanicolaou. George Papanicolaou was the creator of the Pap test.
A Pap smear is a procedure during which cells are gently scraped from your cervix. Your cervix is the lower, narrow end of your uterus that sits on top of your vagina. The collected cells will be sent to a testing lab and checked for signs of cervical cancer or cell changes that may eventually lead to cervical cancer.
A Pap test may also uncover certain other conditions, such as inflammation or infections. A Pap smear is sometimes done along with a pelvic exam. It may also be used to test for certain types of human Papillomavirus (HPV), a common sexually transmitted infection that can lead to cervical cancer.
What is the Pap Smear Procedure Like?
Undergoing the procedure for a Pap smear is not painful, although you will feel some mild discomfort that lasts for just a small amount of time. When you arrive for your appointment, you may be asked to undress completely or only from the waist down. You will then be positioned on your back on an examination table with your legs wide apart, your knees bent, and your feet inserted in stirrups. Your lower body will be covered with a sheet to preserve your privacy.
Your doctor will insert an instrument called a vaginal speculum into your vagina to keep your vaginal walls apart so that your doctor can easily see your cervix. A small sample of cells from your cervix will be removed using a tiny spatula and a small cone-shaped brush. Depending on the type of testing that will be done, the cell samples will be transferred to a glass slide (conventional Pap smear) or a liquid-filled vial (liquid-based Pap test) for testing.
Why Should I Get a Pap Smear?
Detecting cervical cancer in its early stages gives you a much better chance of a positive outcome. A Pap smear is also used to identify changes in your cervical cells that may lead to cancer in the future. Finding these abnormal cells early is your first step in halting the possible development of cervical cancer.
How Often Should I Get a Pap Smear?
Current guidelines recommend repeating Pap testing every three years for women aged 21 to 65. Women aged 30 and above should have a Pap test every five years if the procedure is combined with testing for HPV. If you have certain risk factors, your doctor may recommend more frequent Pap smears. These risk factors include:
- A previous diagnosis of cervical cancer or precancerous cells.
- Prenatal exposure to diethylstilbestrol (DES).
- HIV infection.
- A weakened immune system due to chemotherapy, heavy corticosteroid use, or an organ transplant.
- A history of smoking
Can I Ever Stop Getting Pap Smears?
In certain situations, a doctor may advise you that Pap testing is no longer necessary. Such circumstances include:
- Following a Total Hysterectomy. This procedure involves the surgical removal of the uterus, including the cervix. If you had a hysterectomy because of a noncancerous condition (e.g., uterine fibroids), you might not need routine Pap tests. However, if your hysterectomy was for a cancerous or precancerous cervical condition, you may be advised to continue with regular Pap tests. Even after the cervix has gone, cells can be scraped from an area called the vaginal cuff to check for signs of vaginal cancers.
- Age. Doctors generally agree that women can stop routine Pap testing at age 65 if their previous tests have shown no signs of cervical cancer.
How Do I Prepare for a Pap Smear?
To ensure that your Pap smear will produce the best test results with the least amount of discomfort, here is some advice to follow:
Avoid sexual intercourse, douching, or using spermicidal preparations or any kind of vaginal medicine for two days prior to your Pap smear appointment. These substances may obscure or wash away any abnormal cells.
- Don’t schedule your Pap smear when you expect to be menstruating. If your period arrives early, reschedule your appointment.
- When you are lying on the examination table, try to relax. If you are tense, you may experience more discomfort than is necessary. Try wearing headphones and listening to music on your phone.
- The procedure may feel more uncomfortable if you have a full bladder, so try to urinate beforehand.
What Do My Pap Test Results Mean?
If your Pap test reveals only normal cervical cells, your result will be called negative, and you won’t need any further treatment. If unusual or abnormal cells are discovered, your result is said to be positive. How a positive result is interpreted is dependent upon what type of cells were found and doesn’t necessarily mean you have cervical cancer.
Your doctor may recommend a colposcopy, a procedure that uses a magnifying tool (colposcope) to look at the tissues of the cervix, the vagina, and the vulva. A tissue sample (biopsy) may also be taken from any areas that appear abnormal and sent to a laboratory for analysis.
Although a Pap test is a reliable way to screen for cervical cancer, it is not foolproof. The test may produce a false-negative result, meaning that no abnormal cells show up even though they are present. A false-negative result may be caused by several factors, including:
- An inadequate collection of cells.
- Only a small number of abnormal cells.
- Inflammatory cells or blood obscuring the abnormal cells.
However, even if abnormal cells go undetected, the good news is that time is on your side because cervical cancer may develop slowly over several years. If one test doesn’t find the abnormal cells, the next test very likely will. So, although you may not look forward to your next Pap smear, it is important to schedule it and keep your appointment.
If you live in our area, North Texas Medical Center has healthcare providers that specialize in women’s health. Contact us for your next pelvic exam and Pap smear.