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University of Wyoming

PAP SMEAR

WHAT IS IT, WHY YOU NEED IT, AND WHAT IT MEANS

A Pap smear is a test to look at a sample of cells from the cervix of a female. It is named after it’s inventor, Dr. George Papanicolaou, and has been in use for over 50 years. The sample is obtained during a gynecologic exam. It is an effective screening test to prevent and diagnose cervical cancer, as it can detect abnormalities in the cervical cells at an early stage, when treatment can be more effective. It is recommended that all women start having yearly gynecologic exams, and the Pap smear test, at age 18, or younger if you are sexually active. The best time to obtain this test is 1½-3 weeks after your menstrual period. You should not put anything in the vagina - douche, tampon, intercourse - for the 48 hours prior to your exam.

The Pap test is not 100% accurate, but has been one factor in the drop of rates of cervical cancer by 70% since it’s introduction. The Pap smear result that is reported as "within normal limits" makes certain that there is an adequate sample of cells for evaluation. If your Pap smear is abnormal, it does not mean you have cervical cancer. Rather, there are several possibilities:

  • inadequate sample: not enough cells to analyze.
  • inflammation or hyperkeratosis: possible presence of an infection or thickened cells.
  • Atypical cells: cells that do not look completely normal, and may be an early sign of precancerous changes.
  • Squamous intraepithelial lesion (SIL): precancerous changes in the cervical cells that, if left untreated, can lead to cervical cancer. SIL can be low grade (LSIL) or high grade (HSIL).
  • Atypical glandular cells:  cell changes show that further testing is needed because of an increased risk of precancer or cancer.
  • Invasive cancer: malignancy that has grown into the underlying tissue of the cervix. This is 80 - 90% curable if detected early.

A Pap smear is a screening test.  Further testing methods, such as colposcopy and biopsy may be required for an abnormal Pap smear, to definitively determine the abnormality and appropriate treatment.

You may recently have heard of reports in the media that a newer test, for Human Papilloma Virus (HPV), may be more accurate than a Pap smear for detecting cervical cancer. HPV is associated with about 90% of cervical cancers, and is a sexually transmitted disease. At present, testing for HPV does not replace the Pap smear test, but can be used to give more information to help in treatment decisions.

 

Pap smear testing, and the HPV test, are available at the UW Student Health Service. You can make an appointment with a health care clinician for testing, or for further discussion to determine what is necessary for you. Finally, here are some sources of information on the Internet:

 

http://acog.org : patient information from the American College of Obstetricians and Gynecologists

http://womenshealth.about.com/cs/papsmears/a/pap101smears.htm

 

http://www.4woman.gov/faq/pap.htm : The National Women’s Health Information Center

http://www.healthfinder.gov : a "gateway" to health and human services information pages

http://www.papsmear.org : you can register and get a yearly reminder to get your Pap smear test