Pap Smear

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The Pap smear is a screening test for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus that opens in the vagina.


How is it done?

You lie on a table and spread your legs apart. The doctor gently places an instrument called a speculum into the vagina to open it slightly. This allows the doctor to see inside the vagina and cervix.Cells are gently scraped from the cervix area. The sample of cells is sent to a lab for examination.


Avoid scheduling your Pap smear while you have your period (are menstruating). Blood may make the Pap smear results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your doctor will determine if the Pap smear can still be done.Empty your bladder just before the test.


A Pap smear may cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may bleed a little bit after the test.


The Pap smear is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap smears.


Screening should start at age 21. 



A normal result means there are no abnormal cells present. The Pap smear test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly, and follow-up Pap smears should find any changes in time for treatment.

Abnormal results are grouped as follows:



  • This result means there are atypical cells, but it is uncertain or unclear what these changes mean

  • The changes may be due to HPV

  • They may also mean there are changes that may lead to cancer 


LSIL (low-grade dysplasia) or HSIL (high-grade dysplasia): 

  • This means changes that may lead to cancer are present

  • The risk of cervical cancer is greater with HSIL 


Carcinoma in situ (CIS): 

  • This result most often means the abnormal changes are likely to lead to cervical cancer if not treated 


Atypical squamous cells (ASC): 

  • Abnormal changes have been found and may be HSIL 


Atypical glandular cells (AGC): 

  • Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus 


When a Pap smear shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the Pap smear, your previous history of Pap smears, and risk factors you may have for cervical cancer.


For minor cell changes, doctors will recommend another Pap smear in 6 to 12 months.


Follow-up testing may include:

  • Colposcopy-directed biopsy

  • An HPV test to check for the presence of the HPV virus types most likely to cause cancer.

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