Pap Test

A Pap Test, also known as a Pap Smear, is a test performed to look for abnormal cell changes within the cervix.

The cervix is part of the female reproductive system that connects the uterus or womb to the vagina. The cells of the cervix may sometimes undergo abnormal changes leading to formation of benign tumors such as fibroids, cysts, and polyps, as well as precancerous lesions that can lead to cervical cancer.

Indications 

A Pap Test may be recommended for screening for cervical cancer in women from the age of 21 every 1 to 3 years depending on the results of the last Pap test and the risk factors for cervical cancer which include:

• Sexual activity
• Human papillomavirus (HPV) infection
• Human immunodeficiency virus (HIV) infection
• Sexually transmitted infections
• Multiple childbirths
• History of smoking
• Use of oral contraceptives

Preparing for a Pap Test

To improve the accuracy of the Pap Test you should:

• Avoid sexual intercourse for 2-3 days.
• Do not use tampons, douches, vaginal creams or powders, or birth control foams for 2-3 days to prevent washing off abnormal cells from the cervix.
• Schedule the Pap test about 5 days after your menstrual period ends.

Pap Test Procedure

The Pap test procedure involves the following steps:

• You will wear a hospital gown and lie on your back on the examination table.
• A lubricated instrument, known as a speculum, is carefully inserted into your vagina.
• The speculum slowly spreads apart the vaginal walls for improved viewing.
• A visual inspection of the cervix is performed.
• A cervical brush or cotton swab is used to gently scrape some cells from the walls of the cervix. You may experience a slight discomfort or pulling sensation during the collection process.
• The speculum is then gently withdrawn.
• The obtained cells are smeared over a glass slide or placed in a container containing liquid and sent for pathological evaluation.

After the Pap Test

You may experience a slight amount of vaginal bleeding. This is considered normal and will stop on its own. You can return to routine activities immediately after the test.

Risks and Limitations of a Pap Test

A Pap test is safe way to screen for cervical cancer; however, there is minimal risk of excessive bleeding and cramping pain as a result of the procedure. Either of these should be brought to your doctor’s notice as soon as possible. It is also possible to obtain a false-negative result due to:

• Inadequate sample collection
• Presence of a small number of abnormal cells
• Presence of inflammatory cells that obscure the abnormal cells.

Summary

A Pap test plays a critical role in detecting precancerous cervical lesions or cervical cancer at a very early stage. It involves gathering a sample of cells from the cervix, which are then examined under a microscope by a pathologist. You should follow your doctor’s recommendations for screenings as early diagnosis and treatment increase the likelihood of positive patient outcomes.