A Pap smear is a test that checks for changes in the cells of your cervix. Developed over forty years ago by Dr. George Papanicolaou, this test can help to detect cervical cancer at an early stage while it is easier to treat.
Pap smears have made it possible to detect precancerous and cancerous conditions before they progress to cancer which could spread to other parts of the body, and have saved thousands of women’s lives by catching cancers before they spread.
Pap smears are not 100% accurate. Occasionally, the results indicate normal cell growth but abnormal cells are actually present. This is called a false-negative test. False-negative tests can occur for several reasons. The abnormal cells may not have been contained in the sample. There may have been too many or too few cells to allow an accurate reading. An infection could also cover up abnormal cells. If a Pap smear is performed on a regular basis, the chances of a problem going undetected are lower.
In preparation for a Pap smear do not douche or use vaginal creams for two days prior to the test. Do not have intercourse within twenty-four hours of the test because it could cause inaccurate test results.
A Pap smear only takes a few moments to collect and is a part of a routine pelvic examination. You will be asked to lie on your back, with your knees bent and feet apart. Your clinician will insert a speculum, without lubricant, into the vagina so that the cervix can be seen. Your clinician will use a special swab, brush, or stick to wipe off cells from inside the opening of the cervix and from the outer part of the cervix. These cells are smeared onto a microscope slide and taken for analysis.
If the cells appear normal, no treatment is necessary. If an infection is present, treatment is prescribed. If the cells appear abnormal, more tests may be necessary and, depending on the severity of the dysplasia, natural treatments should begin.
The frequency of the Pap smear test can vary from every six months to every three years depending on a woman's risk factors. These factors include age at the time of first sexual intercourse; multiple sex partners; history of herpes infection or venereal warts; or previously abnormal Pap smears.
Cervical cancer could be eliminated as a cause of death if all women had an annual Pap test. Unfortunately fewer than 49% of all women take the test. Controversy regarding cervical cancer screening concerns the upper age limit for screening and the appropriate frequency.
In 2012, the ACS-ASCCP-ASCP recommendations include these changes from the previous ACS guidelines:
- All women should start screening at age 21. No longer is screening recommended three years after starting vaginal intercourse.
- Women aged 21 to 29 should get a Pap test (conventional or liquid-based) every three years. The statement specifically recommends against annual Pap testing. The former guideline called for a conventional Pap test every year, or a liquid-based Pap test every two years, for this age group.
- For women 30 and over, Pap tests should be done every three years. The guidelines recommend against annual or more frequent Pap testing for this age group. The previous guidelines said women 30 and over who have had three normal Pap tests in a row may be tested less often -- every two to three years.
- Combining the Pap test with HPV testing every three to five years is the preferred strategy for women aged 30 and older.
- Screening is not recommended for women 65 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the past 10 years, or who have had two or more negative HPV tests in the past 10 years.