The Pap smear
The Pap smear
Uterus
Uterus
Pap smear
Pap smear

Pap smear

Definition:
A pap smear is a microscopic examination of cells scraped from the cervix.

Alternative Names:
Papanicolaou test

How the test is performed:

You will be asked to lie on your back with your feet in the stirrups. A pelvic examination will be done, and a speculum (an instrument used to open the walls of the vaginal canal in order to examine the interior) will be inserted into your vagina and opened slightly.

A sample of cells from the outside and the canal of the cervix is taken by gently scraping the outside of the cervix with a wooden or plastic spatula, then inserting a small brush that looks like a pipe cleaner into the canal.

The cells are placed on a glass slide and sprayed with a fixative, or put in a bottle containing a preservative, then sent to the lab for examination.

How to prepare for the test:

The health care provider should be notified of a prior abnormal Pap smear, if you might be pregnant, and if you are taking any medications or birth control pills. You should avoid douching, using tampons, having intercourse, and tub bathing 24-hours before the test.

You should avoid scheduling for your pap smear while you are menstruating because blood and cells from the endometrial cavity may obscure the accuracy of the Pap smear. Empty your bladder just before the test.

How the test will feel:
There may be some discomfort and a feeling of pressure during the procedure. A small amount of bleeding may occur after the test.
Why the test is performed:

The Pap smear can detect cancerous or precancerous conditions of the cervix.

For recommendations on the frequency of having this test done, see also the information on cervicitis.

Normal Values:
A normal value is when the test is negative, meaning there are no abnormal cells present.
What abnormal results mean:
Abnormal values are based on the test results. The current system of reporting divides the results into three main areas: benign or noncancerous, precancerous or showing some abnormal cell changes, and malignant or possibly cancerous.

A report in the latter two categories will usually lead to a follow-up examination, including a repeat Pap smear and possibly other tests. If you have never had an abnormal Pap smear before, and the result indicates a mild abnormality, the Pap test is repeated in 6 months.

If the test result suggests a severe abnormality or cancer, you should undergo immediate colposcopic evaluation with biopsies. If you have had an abnormal Pap test in the past, or have had treatment for a precancerous change, you should have an immediate colposcopy.

What the risks are:
There are no risks involved.
Special considerations:
The following drugs may affect the Pap smears:
  • Colchicine
  • Estrogen
  • Podophyllin
  • Progestins
  • Silver nitrate
  • Cigarette smoking

Review Date: 1/18/2002
Reviewed By: Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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