• A Pap smear is a simple, quick, and virtually painless screening (procedure) for cancer or the uterine cervix’s precancer.
• Cells collected from a woman’s cervix during a pelvic exam are spread on a microscope slide for examination.
• The cells are evaluated for abnormalities, specifically for precancerous and cancerous changes.
• A woman may experience a small amount of spotting (light vaginal bleeding) immediately after a Pap smear, but heavy or excessive bleeding is not normal.
• Cervical cancer screening is recommended every three years for women aged 21-65.
• The Pap smear is analyzed according to a uniform standardized system known as the Bethesda System.
• An abnormal Pap smear may show precancerous changes that can be treated at an early stage before cancer develops.
• A recording of the woman’s menstruation status and whether and when she had abnormal Pap smears previously is essential to the reader of the current Pap smear.
• Up to 80% of women diagnosed with invasive cancer of the cervix have not had a Pap smear in the past five years.
• Cancer of the cervix is mostly a preventable disease.
A Pap smear (Papanicolau smear, also known as the Pap test) is a screening test for cervical cancer. The test itself involves the collection of a sample of cells from a woman’s cervix (the end of the uterus that extends into the vagina) during a routine pelvic exam. The cells are placed on a glass slide and stained with a substance known as Papanicolau stain. The stained cells are then examined under a microscope to look for pre-malignant (before-cancer) or malignant (cancer) changes.
A Pap smear is a simple, quick, and relatively painless screening test. Its specificity, which means its ability to avoid classifying a routine smear as abnormal (a “false positive” result), while very good, is not perfect. The sensitivity of a Pap smear, which means its ability to detect every single abnormality, while good, also is not excellent, and some “false negative” results (in which abnormalities are present but not detected by the test) will occur. Thus, a few women develop cervical cancer despite having regular Pap screening.
In the vast majority of cases, a Pap test does identify minor cellular abnormalities before they have had a chance to become malignant, and at a point when the condition is most easily treatable. The Pap smear is not intended to detect other forms of cancer, such as the ovary, vagina, or uterus. Cancer of these organs may be discovered during the gynecologic (pelvic) exam, usually done at the same time as the Pap smear.
Guidelines have been developed for cervical cancer screening that addresses the frequency with which women should have Pap smears. The US Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend that all women receive cervical cancer screening every three years between the ages of 21 and 65. A Pap smear is the typical screening procedure, but when a Pap smear is combined with a test for human papillomavirus (HPV, the known cause of cervical cancers), screening every five years is acceptable for women aged 30 and above.
Pregnancy does not prevent a woman from having a Pap smear; therefore, Pap smears can safely perform Pap smears during pregnancy.
• Pap smear testing is not indicated for women who have had a hysterectomy (with the removal of the cervix) for benign conditions. Women who have had a hysterectomy in which the cervix is not removed should continue screening.
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