What is a Pap Test?
The Pap Smear, also called a Pap Test, checks for changes in the cells of the cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can tell if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.
A Pap Smear can save your life. It can find the earliest signs of cervical cancer. If caught early, the chance of curing cervical cancer is very high. Pap tests also can find infections and abnormal cervical cells that can turn into cancer cells. Treatment can prevent most cases of cervical cancer from developing. Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a 70 percent decline in the number of cervical cancer cases and deaths.
It is important for all women to have Pap tests, along with pelvic exams, as part of their routine health care. You need a Pap test if you are:
- 21 years or older
- under 21 years old and have been sexually active for 3 years or more
There is no age limit for the Pap test. Even women who have gone through menopause (when a woman’s periods stop) need regular Pap tests. Women ages 65 to 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years
The Physician ultimately decides on how often patients have Pap Smears performed. Below are the general guidelines on how often they should be done, though this has recently bought into question on the below criteria may be too frequent to perform Pap Smears if previous tests are normal.
It depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:
- If you are younger than 30 years old, you should get a Pap test every year.
- If you are age 30 or older and have had 3 normal Pap tests for 3 years in a row, talk to your doctor about spacing out Pap tests to every 2 or 3 years.
- If you are ages 65 to 70 and have had at least 3 normal Pap tests and no abnormal Pap tests in the last 10 years, ask your doctor if you can stop having Pap tests.
You should have a Pap test every year no matter how old you are if:
- You have a weakened immune system because of organ transplant, chemotherapy, or steroid use
- Your mother was exposed to diethylstilbestrol (DES) while pregnant
- You are HIV-positive
Women who are living with HIV, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S. Centers for Disease Control and Prevention recommends that all HIV positive women get an initial Pap test, and get re-tested 6 months later. If both Pap tests are normal, then these women can get yearly Pap tests in the future. Women who are 65 years or age with several normal Pap smears do not need to tested. Women who do not have a cervix after having a hysterectomy do not need to be tested.
The way to reduce the incidence of cervical cancer is to avoid being exposed to the HPV virus.
HPV is a major cause of cervical cancer. HPV infection is also one of the most common sexually transmitted diseases (STD’s). So, a woman boosts her chances of getting cervical cancer if she:
- Starts having sex before age 18
- Has many sex partners
- Has sex partners who have other sex partners
- Has or has had a STD
Human Papilloma Viruses (HPV) are a group of more than 100 different viruses.
- About 40 types of HPV are spread during sex.
- Some types of HPVs can cause cervical cancer when not treated.
- HPV infection is one of the most common sexually transmitted infections (STI).
- About 75 percent of sexually active people will get HPV sometime in their life.
- Most women with untreated HPV do not get cervical cancer.
- Some HPVs cause genital warts but these HPVs do not cause cervical cancer.
- Since HPV rarely causes symptoms, most people don’t know they have the infection.
Most women never know they have HPV. It usually stays hidden and doesn’t cause symptoms like warts. When HPV doesn’t go away on its own, it can cause changes in the cells of the cervix. Pap tests usually find these changes.
Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix. So, doctors suggest that for 2 days before the test you avoid:
- Using tampons
- Using vaginal creams, suppositories, and medicines
- Using vaginal deodorant sprays or powders
- Having sex
Pap tests are not done when you are on your menstrual cycle. The best time to be tested is 10 to 20 days after the first day of your last period.
Your doctor can perform a Pap Smear during a pelvic exam. While you lie on an exam table, the doctor puts an instrument called a speculum into your vagina, opening it to see the cervix. A special brush or stick is used to remove a few cells from inside and around the cervix. The cells are placed on a glass slide and sent to a lab for examination. Pap smears are normally painless.
Pap Smear results usually take 2 to 3 weeks to return. Usually it takes 3 weeks to get Pap test results. If the test results are suggestive of an abnormality, your doctor will contact you to schedule more tests. There are many reasons for abnormal Pap test results. Normally it does not mean you have cancer.
There are many reasons for “abnormal” Pap test results. If results of the Pap test are unclear or show a small change in the cells of the cervix, your Physician will probably repeat the Pap test.
If the test finds more serious changes in the cells of the cervix, the doctor will suggest further testing. Results of these tests will help your doctor decide on the best treatment. These include:
- Colposcopy: The use of an instrument called a colposcope to see the cells of the vagina and cervix in detail.
- Endocervical curettage: The doctor takes sample of cells from the endocervical canal with a small spoon-shaped tool called a curette.
- Biopsy: The doctor removes a small sample of cervical tissue. The sample is sent to a lab to be studied under a microscope.
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