What Is a Pap Smear?
Cancer of the cervix (cervical cancer) is the fourth most common cause of cancer-related death among women worldwide. The best way to detect cervical cancer is by having regular Papanicolaou tests, or Pap smears. (Pap is a shortened version of the name of the doctor who developed the screening test). A Pap smear is a microscopic examination of cells taken from the uterine cervix.
A Pap smear can detect certain viral infections such as human papillomavirus (HPV), which is known to cause cervical cancer. Early treatment of precancerous changes detected on the Pap smear can stop cervical cancer before it fully develops. A woman may have cervical cancer and not know it because she may not have any symptoms.
The incidence of cancer and deaths from cervical cancer has significantly declined over the years because of prevention, screening, and early detection by the Pap smear. Most abnormal Pap smear results indicate the early stages of disease and need reasonable observation by a doctor.
Risks factors for cancer of the cervix include conditions that increase the likelihood of being infected with HPV as well as other factors including the following:
- Multiple sexual partners (or sexual partners who have had multiple partners)
- Starting sexual intercourse at an early age
- Weakened immune system
- Previous cancer of the lower genital tract
New recommendations were published in March, 2012 by the U.S. Preventive Service Task Force with agreement by the American Cancer Society (details are described further in this article). Briefly stated, cervical cancer screening is now recommended every 3 years starting at age 21. Screening may be carried out every 5 years for women over age 30 if a Pap smear and HPV test are performed.
No upper age limit for screening exists because the incidence of cancer of the cervix increases with age at a time when women may be less likely to get a Pap smear. Diagnosis of most of these cancers is in women older than 50 years. Even after menopause, a woman should continue to have regular Pap smears. Women over age 65 who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having Pap tests.
If a woman has had her uterus removed, she should still have yearly screening if there is a history of advanced precancerous changes seen on Pap smear or other lower genital tract cancer.
What Are the Risks of a Pap Smear?
The Pap smear procedure is not complicated or painful. The only risk is not detecting cervical cancer in time to treat and cure it.
How Do I Prepare for a Pap Smear?
The best time to have a Pap smear is when the woman is not menstruating.
For two days before the test, avoid the following because these might interpretation of the test more difficult:
- Vaginal medications (except as directed by your doctor)
- Vaginal contraceptives such as birth control foams, creams, or jellies
Medically Reviewed by a Doctor on 11/23/2016
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