The Pap test (also known as Pap or cytology ) is a way to examine cells collected from the cervix and vagina.
This test can show the presence of infection, inflammation, abnormal cells, or cancer.
- What is a pelvic exam?
In a pelvic exam, the doctor feels the uterus (womb), vagina, ovaries, fallopian tubes, bladder, and rectum, in order to find any abnormalities in their shape or size.
During the pelvic exam, an instrument known as a speculum is used to widen the vagina so that the upper part of the vagina and cervix can be seen.
- Why are Pap tests and pelvic exams important?
The Pap test and pelvic exam are an important part of a woman’s routine health care, as they can detect abnormalities that can lead to invasive cancer.
These abnormalities can be treated before cancer develops.
Most invasive cancers of the cervix can be prevented by having regular Pap tests and pelvic exams.
Also, like other cancers, cervical cancer can be most successfully treated when it is found early.
- Who performs the test?
Doctors and other health professionals, such as physician assistants, midwives, and nurse practitioners, can perform Pap tests and pelvic exams.
- How is it done?
The Pap test is simple, quick, and painless; You can test, a sample of cells is removed from inside and around the cervix with a plastic scraper or a small cervical brush.
The specimen (sample) is put on a glass slide or washed in fixative fluid and sent to a laboratory for examination.
- Who should be daddy?
Women who are or have been sexually active, or older than 18, should have regular Pap tests and physical exams.
It would be good for women to consult their doctor about how often to have these tests.
It is not known of an age the pap stops being effective. Older women should continue to have regular physical exams, including a pelvic exam and Pap smear.
Women who have had consistently normal test results might ask their doctor how often they should have Pap tests.
Women who have had a hysterectomy (surgery in which the uterus, including the cervix, is removed) should check with their doctor about whether they need to continue regular Pap tests.
If the hysterectomy was done because of a precancerous or cancerous condition, they will still need to take samples from the end of the vaginal canal to determine abnormal changes.
If the uterus (including the cervix) has been removed due to a non-cancerous condition such as fibroids, routine Pap tests may not be necessary.
However, it is still important that women continue to have regular gynecological exams as part of their health care.
- When should the test be done?
A woman should have this test when she is not menstruating; the best time is between 10 and 20 days after the first day of the menstrual period.
Two days before the Pap test, the woman should avoid douching or use vaginal medications or spermicidal foams, creams, or gelatins (except when directed by the doctor). These could confuse the results of the panicolaou test.
The Bethesda System is a reporting method that uses descriptive diagnostic terms instead of class numbers, which have been used in the past to present Pap test results.
This reporting system includes a specimen adequacy assessment. For more information on this system, read the following article: Pap Test Results Report
- What do abnormal test results mean?
A doctor might just describe the Pap results as “abnormal.” Cells on the surface of the cervix sometimes look abnormal but are not cancerous.
It is important to remember that abnormal conditions do not always turn into cancer, and some conditions can be more serious than others.
It is advisable for a woman to ask her doctor for specific information about her test result and what it means.
There are several terms that can be used to describe abnormal results:
- Dysplasia is a term used to describe abnormal cells. Dysplasia is not cancer, although it can develop into early cancer of the cervix.
During dysplasia, cervical cells undergo a series of changes in their appearance. The cells appear abnormal under the microscope, but they do not invade the healthy surrounding tissues. There are three grades of dysplasia, classified as mild, moderate, or severe, depending on how abnormal the cells look under the microscope.
- Squamous intraepithelial lesion (SIL) is another term used to describe abnormal changes in
cells on the surface of the cervix.
The word squamous describes cells that are thin, flat, and lie on the outer surface of the cervix.
The word injury refers to abnormal tissue. An intraepithelial lesion means that the abnormal cells are present only in the superficial layers of the cells.
A doctor may describe a squamous intraepithelial lesion as low-grade (early changes in the size, shape, and number of cells) or high-grade (a large number of precancerous cells that appear quite different from normal cells).
- Cervical intraepithelial neoplasia (CIN) is another term that is sometimes used to describe abnormal cells.
Neoplasia means abnormal new growth of cells. Intraepithelial refers to the surface layers of cells.
The term cervical intraepithelial neoplasia, along with a number (1 to 3), describes how much of the cervix
contains abnormal cells.
- Carcinoma in situ describes a pre-invasive cancer that involves only superficial cells and has not spread to deeper tissues.
- Cancer of the cervix, or invasive cancer of the cervix , occurs when abnormal cells penetrate deeper into the cervix or other tissues or organs.
- How do these terms compare with each other?
- Mild dysplasia can also be classified as low-grade SIL or CIN 1.
- Moderate dysplasia can also be classified as high-grade SIL or CIN 2.
- Severe dysplasia can also be classified as
high- grade SIL or CIN 3.
- Carcinoma in situ can also be classified as
high- grade SIL or CIN 3.
What are atypical squamous cells of undetermined significance (ASCUS)?
Abnormalities that do not meet the criteria for defining a squamous intraepithelial lesion (SIL), cervical intraepithelial neoplasia (CIN), or dysplasia are called atypical squamous cells of undetermined significance (ASCUS).
Persistently abnormal samples are usually evaluated in more detail by a physician. Be recommended to read the article What does ASCUS mean?
- Is the human papillomavirus associated with the development of cancer of the cervix?
Human papillomaviruses are viruses that can cause warts. Some are sexually transmitted and cause wart-like growths on the genitals.
Scientists have identified more than 70 types of human papillomavirus; 30 types infect the cervix, and about 15 types are associated with cervical cancer.
The human papillomavirus is a major risk factor for cancer of the cervix. In fact, almost all cervical cancers show evidence of human papillomavirus.
However, not all cases of the virus develop into cancer of the cervix. A woman with the human papillomavirus should report any concerns to her doctor.
- Who is at risk for Human Papillomavirus infection?
This infection is more common among youth groups, particularly in women between 16 and 20 years of age. Because the human papillomavirus is spread primarily through sexual contact, the risk increases with the number of sexual partners.
Women who become sexually active at a young age, who have multiple sexual partners, and whose partner is detectable for years after infection.
Is infection with a type of human papillomavirus always associated with cancer or a precancerous condition or cancer?
No. Most infections seem to clear up on their own without causing any abnormalities. However, infection with types of human papillomavirus associated with cancer can increase the risk that mild abnormalities will develop into more serious abnormalities or cancer of the cervix.
With regular medical monitoring by trained clinicians, women with precancerous cervical abnormalities should not develop invasive cancer of the cervix.
What do false positive and false negative results mean?
Unfortunately, there are times when the Pap results are not accurate. Although these errors do not occur very frequently, they can cause anxiety and can affect a woman’s health.
A false positive result occurs when a patient is told that she has abnormal cells when in fact the cells are normal.
A false negative result occurs when a specimen is called normal, but the woman has a lesion. A variety of factors can contribute to a false negative result.
A false negative result can delay the diagnosis and treatment of a precancerous condition.
However, regular screening tests help compensate for false negatives because if cancer cells were not detected by mistake one time, there is a good chance that the cells will be detected the next time.
What if my Pap test results are abnormal?
If the test shows an ambiguous or minor abnormality, the doctor may repeat the test to ensure its accuracy.
If the test shows a significant abnormality, the doctor may then perform a colposcopy using an instrument much like a microscope (called a colposcope) to examine the vagina and cervix.
The colposcope does not penetrate the body. A Schiller test can also be done. To perform this test, the doctor lines the cervix with an iodine solution. Healthy cells turn brown and abnormal cells turn white or yellow. Both of these procedures can be done in the doctor’s office.
The doctor may also remove a small amount of cervical tissue for examination by a pathologist. This procedure is known as a biopsy and it is the only way to know for sure if abnormal cells indicate cancer.