In India, nearly 6-29% of cancer cases in women have been detected as cervical cancer. Even though the percentage is concerning, individuals can defend themselves from cervical cancer by opting for a routine screening. Pap smear tests are one of the most effective screening programs for cervical cancer.

As per IARC (International Agency for Research on Cancer), regular screening can reduce the mortality rate of cervical cancer-affected females by 80%. Thus, every woman needs to know how a Pap smear test is done and why it is important. Keep reading for a detailed insight into the purpose, procedure, and results of the Pap smear test.

What is a Pap Smear? 

A Pap smear test is performed to examine cervical cancer in women. In this test, the doctor will collect cells from the cervix (the lower, narrow end of the uterus, connected to the vagina) to detect any cancerous growth. 

This test can detect any changes in the cervical cells that may lead to cancer later. A Greek doctor, Georgios Papanikolaou, first invented this test, which is named the “Pap smear test” after him.

What are the Uses of Pap Smear?

Besides detecting cervical cancer, the Pap smear test is used to diagnose infections and monitor cervical health. The uses or purposes of a Pap smear test are explained below:

• Screening

A Pap smear test helps detect precancerous changes in the cervix at an early stage. Early detection of abnormal cells before cancerous development helps reduce the risks of cervical cancer. Routine screening will help identify if HPV (human papillomavirus) has caused any changes in the cervical cells, preventing cancer in your cervix.

• Diagnosis

A Pap smear test can diagnose abnormal cervical cells that indicate infection, precancerous conditions, or other issues. Depending on the severity of the condition, biopsy, colposcopy, etc., are recommended diagnostic procedures upon detecting abnormal cells.

Sometimes, doctors suggest an HPV test along with a Pap smear to check if your cervix has any high-risk strains of HPV. The presence of these strains can lead to cervical cancer.

• Monitoring

Regular Pap smears are essential for women treated for cervical cancer or precancerous lesions to monitor treatment effectiveness and prevent recurrence. Women with weakened immune systems, cervical abnormalities, or diethylstilbestrol (DES) exposure may require more frequent screenings to detect and prevent cervical cancer progression.

How often is a Pap Smear Test Required?

The frequency of a Pap smear test depends on the following factors:

• Health history
• Age
• Results of HPV test or previous Pap test.

Generally, women over 65 years do not require a Pap smear test. The following frequency can be followed to perform a Pap test depending on the age:

• Below 21 Years

Women below the age of 21 years generally have lower risks of cervical cancer. Thus, a Pap smear test is not necessary if you are younger than 21 years.

• Between 21 and 29 Years

Women who are aged between 21 and 29 years should opt for a Pap test every 3 years to check for cervical cancer.

• Between 30 and 65 Years

If your age is between 30 and 65 years, getting a Pap test every 3 years or getting a Pap/HPV co-test is advisable to examine your cervical cells.

• Older than 65 Years

If you have never had a history of any abnormality in the cervical cells and have been diagnosed with a Pap test three times in the previous ten years, it is not required after 65 years.

How to Prepare for Pap Smear?

Here are some of the preparations and precautions to follow before a Pap smear test:

• Refrain from using any medicine or vaginal cream, tampons, birth control jellies or foams, douches or lubricants a minimum of two days before appearing for the test.
• Avoid vaginal sex for a minimum of two days after undergoing a Pap smear test.
• It is advised to make an appointment for the Pap smear test after your menstrual cycle ends for the month. If you suspect your menstrual cycle starts on the day of the test or if you are going through it, consult with your doctor before appearing for the test.

Note: It is advised to avoid Pap smear tests during menstruation since it may affect results. Some providers perform tests when bleeding is less, but it’s best to consult your provider for specific guidance or reschedule for a non-menstrual period.

How to Perform Pap Smear Procedure?

Though Pap smear test procedure may vary depending on the patient’s health condition and the techniques of the healthcare provider, here are the general steps followed:

• Step 1: You will be requested to wear a hospital gown and empty your bladder beforehand.
• Step 2: Lie on an exam table with the feet in stirrups, keeping the legs relaxed and spread apart.
• Step 3: A healthcare provider gently inserts a speculum into the vagina to widen it, allowing a clear view of the cervix. This may cause mild pressure or discomfort.
• Step 4: The provider collects cervical cells and mucus using a small brush, spatula, or swab. These are preserved in a liquid vial or smeared on a slide for lab analysis.
• Step 5: Additional samples may be taken for HPV testing or to check for infections.
• Step 6: A pelvic exam may follow the Pap smear.
• Step 7: The collected sample is sent to a lab to examine for abnormal or precancerous cells.

Mild bleeding or discomfort is common but temporary. Results are typically available within 1-3 weeks.

What are the Interpretations of Pap Smear Test Results?

The results of a Pap smear test are interpreted as follows:

Normal Results

• No abnormal cells were detected.
• Often referred to as “negative.”
• No further action is required; the next Pap smear is recommended after three years (or five years if combined with a normal HPV test)

Abnormal Results

• Indicates abnormal cervical cells, which may be precancerous but not necessarily cancer.
• Severity levels include atypia, mild, moderate, severe dysplasia, or carcinoma in situ.
• Milder abnormalities are more common and often resolve naturally.

Follow-Up for Abnormal Results

• Increased frequency of Pap smears may be recommended.
• A colposcopy procedure may be performed to examine cervical tissue more closely using magnification and light.
• A biopsy may be done during colposcopy to collect tissue samples for further analysis.

Unclear or Unsatisfactory Results

• It may require retesting due to inadequate cell samples or ambiguous findings.
• HPV testing might help clarify results.

Early detection and treatment of abnormal cells can prevent cervical cancer progression. It is highly advised to discuss follow-up plans for personalised care with the healthcare provider.

FAQs about Pap Smear Test

1. Is a Pap test necessary if someone has had a hysterectomy?

The necessity of a Pap smear depends on the type of hysterectomy and its factors. Pap smears are still necessary if the cervix remains in your body after a hysterectomy. Without a cervix, tests may not be required unless the hysterectomy was due to cancer, in which case vaginal tissue may still be monitored.

2. Is Pap smears painful?

A Pap smear is generally painless but may cause mild discomfort or light bleeding. If you experience prolonged discomfort or bleeding beyond 24 hours, report it to your healthcare provider for further evaluation.

3. What are the consequences of not having a Pap smear test?

Skipping Pap smears risks undetected cervical cancer, which may progress to life-threatening stages. Early detection via Pap tests identifies abnormal cells before they become cancerous, enabling timely treatment and significantly improving outcomes. Regular screenings are crucial for prevention and early intervention.

4. Are the Pap smear test results always accurate?

Pap smears are highly accurate and reduce cervical cancer rates and mortality by over 80%. Though mildly uncomfortable, the brief discomfort is a small trade-off for early detection and effective prevention of cervical cancer.

5. Is there any risk in getting a Pap smear test?

Pap smears carry minor risks, including brief discomfort, light bleeding, and rare infections. False-positive results can cause unnecessary anxiety and additional testing, but overall, the procedure is safe and crucial for cervical health monitoring.

Conclusion

Every woman, especially between the age group above 21 years and below 65 years, should opt for a routine Pap smear test accompanied by an HPV co-test. It helps detect cervical cancer or any abnormal cell growth in the cervix at an early stage, allowing you to adopt preventive measures. In this regard, seek assistance from DocTutorials. Our study materials cover the Pap smear test and other crucial topics in detail to prepare you for the exam. Moreover, we even conduct subject tests and mini-tests to check your progress. Enroll in our NEET PG course and build your medical career successfully.