PAP SMEAR

The Pap smear is a painless screening test that is performed during the pelvic exam to check for unusual changes in the cells of the cervix. These abnormal cells can develop into cancer if not detected and treated. There are no signs or symptoms related to early cervical cancer so a pelvic exam of the female sex organs and a Pap smear are needed. Cervical cancer is preventable and curable if it is detected early.

Do not schedule the exam when you will be having your period. Do not douche or use vaginal creams or ointments two days prior to the examination. Do not have sexual intercourse one day before the appointment. Be prepared to talk with your provider about any questions or concerns you may have.

Having this exam may be stressful for many women. This is easy to understand since the area being examined is considered private and the exam can be uncomfortable. Most healthcare providers are aware of this discomfort and will help their patients through it. If this is your first pelvic exam, the office staff and provider will be able to explain the procedure before beginning. Knowing what to expect ahead of time helps to relieve stress. The exam will vary depending on individual needs, but will usually include a breast exam, weight and blood pressure checks, and a Pap smear.

Before the exam, you will be asked to empty your bladder. Clothing is replaced with a gown with a cloth draped over you from the waist down. A special examination table is used that allows you to lie on your back and place your feet on extended supports called stirrups to keep your legs spread apart. A female nurse will help you get into position and stay with you during the exam.

The pelvic exam and Pap smear take only a few minutes. The pelvic exam will include checking the skin and glands on the outside opening of the birth canal, or vagina. The provider will gently insert a thin, lubricated piece of plastic or metal instrument that looks like a duck bill into your vagina to hold the vaginal walls open for the Pap smear. This opens the vagina just enough to allow light in to see the surface of the skin and the opening of the womb, called the cervix. It is very important to stay relaxed and to breathe slowly and deeply. This will help keep the abdominal muscles relaxed. For the Pap smear procedure, a small brush and swabs will gently be used to take a few cells from your cervix. You may feel a pulling sensation or no sensation at all. After the Pap procedure, the pelvic exam continues. The samples of cells taken during the Pap smear procedure are tested by a laboratory for infection, cancer, or other conditions. The results for this are given at a later date.

A Pap smear is suggested annually at the onset of sexual activity but no later than 21 years of age. At or after age 30, for women who have had a normal Pap smear for 3 years in a row and do not have a history of cervical cancer in their family, history of infections, or history of multiple sex partners, a healthcare provider may determine it is safe to be tested every 2 to 3 years.

Risk factors associated with cervical cancer include:

failure to receive regular Pap test screening
human papillomavirus (HPV) infection
immunosuppressive disorders such as HIV/AIDS and
certain sexual behaviors including intercourse at an early age, multiple male sexual partners, and sex with a male partner who has had multiple sexual partners

If you have an abnormal Pap smear, you may be scheduled for a repeat Pap smear or colposcopy in a few months. A colposcopy is a close exam of your cervix using a special microscope. Samples will be taken of the areas that look abnormal. Lab test results will determine if more treatment is needed.

Treating pre-cancer tissue after testing may include:

waiting and watching with no treatment and more frequent Pap smears
getting rid of the pre-cancer cells by laser or freezing or
removing the pre-cancer cells with surgery

Remember, cervical cancer can be prevented. Most women should have a well woman's physical examination every year. Doing this will help ensure that changes in a woman's ovaries are diagnosed as early as possible. A healthcare provider performs the exam, which usually includes a pelvic exam and Pap smear.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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