Pap Test or Papanicolaou Test
In Pap smear, a sample of loose cells is gently scraped from the cervix (the lower part of the uterus that opens into the vagina), spread on a glass slide, and sent to a laboratory for microscopic examination. A Pap smear is often done as part of a routine gynecologic examination in women, and is able to detect precancerous and cancerous conditions in their early and most treatable stages.
Alternatively, a new technique known as a liquid-based smear involves placing the scraped specimen into a vial of liquid. This liquid-based material is then studied under a microscope.
Purpose of the Pap Smear
- To check for cervical cell changes that could develop into cancer. It can also detect cancer cells.
- Performed regularly in women after age 18 to 21 (or in younger women who are sexually active) to screen for cancer of the vagina, cervix, and uterus.
- To detect benign cervical abnormalities, such as inflammation of the cervix.
Who Performs Pap Smear
- A gynecologist or a nurse practitioner
Special Concerns about Pap Smear
- The test should not be performed during your menstrual period, since the presence of blood may interfere with the results.
- The best time to schedule a Pap smear is two weeks after the start of your last menstrual period.
- The presence of vaginal or cervical infection or inflammation may result in an abnormal Pap smear in the absence of any malignant or precancerous condition; this is known as a false-positive result and may lead to unnecessary follow-up tests.
Before the Pap Smear
- Tell your doctor if you are taking any medications, including oral contraceptives
- If your doctor is unaware of an abnormal Pap smear result in your past, alert him/her to it.
- Tell your doctor if you think you might be pregnant.
- Do not douche, use tampons or take a bath (showers are OK) a day before your test.
- Avoid having sex 24 hours before your Pap.
- Be sure to inform your doctor of any medications that you regularly take, including oral contraceptives.
- You will be asked to disrobe from the waist down and to put on a drape or hospital gown.
- You will be instructed to empty your bladder before the test.
What You Experience
- You will lie on your back on an examination table, with your knees bent and your feet raised and resting in stirrups.
- A small metal or plastic instrument, called a speculum, is inserted into your vagina. (Insertion may cause slight discomfort, but is not painful.) The speculum holds the walls of the vagina open so that the examiner can view the upper vagina and cervix. Relax and breathe through your mouth to ease the insertion.
- The examiner then wipes a cotton swab, tiny brush, or thin wooden spatula over the cervix to collect cells.
- You may feel some mild discomfort as the sample is obtained.
- The cells are spread on a glass slide and sent to a laboratory for microscopic analysis.
- The speculum is withdrawn.
- The test usually takes about 2 to 3 minutes to perform.
Risks and Complications of Pap Smear
- You may feel some discomfort during the test, which most equate to cramping. You may also feel some pressure.
- A little bleeding after the test may occur.
After the Pap Smear
- You may dress and leave the doctor’s office promptly after the test is completed.
Pap Smear Results
- A pathologist will examine the Pap smear under a microscope for the presence of unusual cells. In addition, several computer programs are currently available to help recognize and classify any abnormal cells.
- In many cases, you will not be notified of your Pap smear results unless further evaluation is needed.
- If your Pap smear is normal, the test will typically be repeated annually, depending on your age, your risk factors, and any abnormalities found on the previous Pap smear.
- If abnormal cells are detected, you may need to undergo further testing—such as colposcopy with a cervical punch biopsy, or pelvic or transvaginal ultrasound—to establish a diagnosis and determine the extent of the problem.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media