The “pap smear,” or “pap test” is a test done for women to detect cervical cancer or early changes in cervical cells that could progress to a cancer. The cervix is the opening or mouth of the uterus, and a pap test involves taking cells off the surface of the cervix with a broom-like device. These cells are then sent to a pathology lab for analysis.
1. WHO SHOULD HAVE A PAP TEST? Sexually active women should have the test yearly. If any abnormal cells are found, they may be asked to do the test more frequently until all abnormalities resolve. Woman over age 18 who have never been sexually active should have a gynecological assessment, but it may not be possible to do a pap test if the hymen is intact.
2. WHAT CAUSES ABNORMAL CERVICAL CELLS? The number one suspected cause is human papilloma virus (HPV), also known as “venereal warts.” It is a sexually transmitted disease, but many individuals are unaware they are infected. The warts may be small and tucked away in hard to see places such as under the scrotum, in the anal area, or inside the vaginal cavity on the cervix. The warts go away in time, but others may break out. It is now believed the body’s defenses will eliminate the wart virus eventually, but it may take years!
3. CAN THE ABNORMAL CELLS BE TREATED? Yes, there are a number of ways to treat them right in the gynecologist’s office. The body’s own defenses may clear up the problem if no intervention is done. There is the risk, however, that the body’s defenses will not be able to do the job, and over months and years the abnormal cells left untreated may progress to cancer.
4. WILL ANY OTHER ROUTINE TESTING BE DONE WITH MY YEARLY PAP SMEAR? Practitioners like the pap test to be part of a complete yearly physical when other exams such as breast exam and blood pressure measurement are also done. It is now also recommended that a chlamydia test be done routinely with pap smear. The test is a simple cotton swab of the cervix. Chlamydia is a widespread sexually transmitted disease that remains symptomatic in many people.
5. IF I AM ASKED TO REPEAT MY PAP SMEAR, DOES IT MEAN ABNORMAL CELLS WERE FOUND? Not necessarily. Sometimes the pathologist may not see enough of the right kind of cells from the broom specimen to do a thorough analysis, or there may be other “technical difficulties”. Do not douche or use vaginal medications for 2-3 days before pap test to aid in getting a good result.