A Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix, or the "mouth" of the womb (located at the top of the vagina), for the presence of:
A Pap test, along with a pelvic examination, is an important part of a woman's routine health care because it may detect abnormalities that can lead to invasive cancer. Most invasive cancers of the cervix can be detected early if women have Pap tests and pelvic examinations regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early.
The Pap test is useful for detecting not only cancerous cells, but also other cervical and vaginal abnormalities including dysplasia (precancerous cells) and inflammation. Inflammation may be caused by:
According to the National Cancer Institute, when the Pap test shows an ambiguous or minor abnormality, the test is usually repeated to ensure accuracy.
If the test shows a significant abnormality, a colposcopy may be performed (using an instrument called a colposcope) to examine the vagina and the cervix.
A Schiller test may also be performed, in which the cervix is coated with an iodine solution. The iodine stains healthy cells brown, while abnormal cells maintain their typical white or yellow color.
A biopsy may be performed in which the physician removes a small amount of cervical tissue for examination by a pathologist. This is the only sure way to determine whether the abnormal cells indicate cancer.
A woman should always consult with her physician about when and how often a Pap test and pelvic examination should be performed.
According to the National Cancer Institute (NCI), the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG), general guidelines include:
In the past few years, a newer way of testing cervical cells for abnormalities has gained acceptance in the medical community. This procedure is called liquid-based cytology. Approved by the US Food and Drug Administration (FDA), the test is a liquid-based procedure in which cells from the cervix are put into a vial of liquid instead of being "smeared" onto a slide. The liquid is then filtered and only the cervical cells are placed onto a slide for examination. Though the cost of the procedure, called Thinprep, AutoCyte, or SurePath, is double what a Pap test costs, studies show that these tests may require fewer repeat tests and detect more early-stage lesions. Consult your physician for more information.
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