Overview Pap Smear & Pap Smear Abnormal
A Pap smear (also known as a Pap test) is an important noninvasive screening tool to help detect cervical cancer or potential risk of the condition. Sometimes, results can come back abnormal for a Pap smear, which may cause concern and requires further understanding. It looks for cervical cell changes on the cervix that might turn into cancer over time. The cervix is the lower end of the uterus.
During a pap smear test, a healthcare provider will gently swipe cells from your cervix. A laboratory is then able to check those cells for signs of abnormal growth. The test is performed in a doctor’s office. It might feel awkward, but it’s generally over fast.
This primer covers what a pap smear is, who needs one, how often it is usually recommended, and what to expect during the test and after you get your results.
Who should get a Pap smear
The American Cancer Society Trusted Source recommends that cervical cancer screening begin at age 25.
Some people need screening more often, especially if they have a higher risk for high-risk HPV infection or cervical changes. Your doctor may suggest a different schedule if:
- you’re HIV-positive
- your immune system is weakened due to chemotherapy or an organ transplant
If you are 25 or older and have had normal Pap results in the past, ask your doctor about whether it’s possible to screen every five years when screening is done together with testing for human papillomavirus (HPV). Current guidelines Trusted sources suggest an HPV test every five years for those aged 25 to 65.
HPV, a virus that can cause warts and increase the chances of contracting cervical cancer. the most common HPV strains that cause cervical cancer are 16 and 18. The vaccine guards against these types. You have higher chances of cervical cell changes if you have HPV.
Most people older than 65 who have been regularly screened and had normal results may stop screening. Your doctor can help determine if it’s safe for you to stop.
You still need to screen regularly even if you are not sexually active right now. HPV can lie dormant for years and become active later.
How frequently you require a Pap smear depends on your age, your test history, and your risk factors.
These guidelines are for those who have a cervix. If you had a hysterectomy in which your cervix was removed and you have no history of cervical cancer, you may not need to be screened.
Screening recommendations may also be modified if you have immune-system problems or a history of precancers or cancer.
Scheduling your test and getting ready
You may have a Pap smear at your annual gynecology visit, where you may also have a pelvic exam, or your visit for the test can take place at an entirely different time. Pap smears are covered by most insurance, but you may still have a co-pay.
If you anticipate that the day of your test will fall during your period or when you have a yeast infection, your doctor might reschedule. Blood can also obscure the reading.
Other sources of “false positives” To ensure an accurate result, try not to do the following the day before your test:
- vaginal sex
- douching
- spermicide products
In general, it’s safe to have a Pap smear during the first 24 weeks of pregnancy. After that, though the intuition is probably pretty good, it could get a bit uglier. Accuracy may be better after waiting about 12 weeks post-delivery.
In general, pap smears go more smoothly when your body isn’t tensed up. Slow, steady breaths can help.
What happens during a Pap smear
A pap smear may be uncomfortable, but it is usually brief.
You will lie on your back on an examination table. Your feet are placed in supports, or stirrups.
Your doctor will insert a speculum into your vagina. This device spreads apart the walls of the vagina so that the cervix is visible.
Next: Your doctor takes a small sample of cervical cells from the cervix. They may use:
- a spatula
- a spatula and a brush
- a cytobrush (a brush designed for cervical cells)
Many people feel mild pressure, along with brief scraping or irritation.
The sample is stored and sent to a lab to check for abnormal cells.
After the test
It’s fairly common to experience mild cramping and/or some tenderness following the exam. Some people also experience light spotting immediately after the test. If you are worried about spotting or cramping that won’t go away, inform your doctor, who can offer follow-up care in the event bleeding and pain continue past the following day.
Pap smear results: normal vs. abnormal
Results of Pap smears typically come in two categories, but you may receive an unsatisfactory Pap test if the sample wasn’t sufficient for assessment.
Normal Pap Test Results
A test result of “normal” indicates that no abnormal cells were found. You might also hear it referred to as a negative result. If your results are normal, depending on your age and your screening plan, you may not need another Pap test for 3 years.
Abnormal Pap Test Results
An abnormal result—often euphemistically referred to as an abnormal Pap smear—does not indicate you have cancer. It signifies some cervical cells do not appear typical. Some will resolve on their own, but some can be a result of cervical dysplasia or precancerous cervical cells.
An abnormal result can be due to mild alterations or more critical abnormalities, such as:
- atypical squamous cells
- low-grade squamous intraepithelial lesions
- high-grade squamous intraepithelial lesions
- atypical glandular cells
- glandular cells
- cervical intraepithelial neoplasia
- squamous cell carcinoma
False positive Pap IN REVIEW Report result. Follow-up tests might prove negative. Depending on your results, your doctor may advise more frequent Pap smear tests or a closer examination of the cervix using a procedure called colposcopy.
During colposcopy, your doctor looks at the cervix and vaginal tissue through a special magnifying device. Sometimes they take a small sample of tissue in a biopsy, and both procedures (colposcopy and biopsy) may be done for a complete examination.
How accurate is a Pap smear?
Pap tests are reliable when done on a regular schedule. Routine cervical cancer screening lowers cervical cancer rates and deaths by at least 80 percent (Trusted Source). The exam may cause brief discomfort, but it can help catch harmful changes in cervical cells early.
Why Pap smears matter, and the role of HPV
A Pap smear looks for early changes in cervical cells. These changes are often detected by a positive HPV test, as it is a loose cause.
HPV can be transmitted through sex with men or women. Condoms or other barrier methods can reduce the risks, but no method is risk-free. Most people who are sexually active will be exposed to HPV at some point, which makes the regular screening so important.
A Pap test does not screen for most other sexually transmitted infections (sexually transmitted diseases). It might sometimes be a clue to other problems, but it should not be used as an STI test.
If you have an abnormal pap smear or abnormal pap test results, your doctor might suggest a colposcopy and biopsy for further examination. Depending on the severity, treatment may involve a loop electrosurgical excision procedure, cone biopsy, or cryosurgery.
Key Takeaways
- A Pap smear is a noninvasive test that detects cervical cancer by screening cervical cells for abnormalities.
- Women should begin Pap smear screenings at age 25, with frequency depending on age and risk factors.
- During the test, a healthcare provider collects cell samples from the cervix using a speculum and sampling tools.
- Results can be normal or abnormal; abnormal results do not mean cancer but may indicate precancerous changes.
- Regular Pap smears are crucial for early detection, and tests are accurate when performed on schedule.
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