Pap Smear

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Cervical Cancer Symptoms

In its early stages, cervical cancer typically does not cause symptoms; however, when symptoms do occur, one of the most common symptoms is abnormal vaginal bleeding. This can include:

  • Bleeding between menstrual periods
  • Bleeding after sexual intercourse or a pelvic exam
  • Bleeding after douching
  • Unusually heavy menstrual bleeding
  • Bleeding after menopause

Other symptoms of cervical cancer may include:

  • Pelvic pain
  • Vaginal discharge
  • Pain during sexual intercourse

Quick GuideCervical Cancer Pictures Slideshow: Symptoms, Stages and Treatment

Cervical Cancer Pictures Slideshow: Symptoms, Stages and Treatment

Pap smear facts

  • A Pap smear is a simple, quick, and essentially painless screening test (procedure) for cancer or precancer of the uterine cervix.
  • Cells collected from a woman's cervix during a pelvic exam are spread on a microscope slide for examination.
  • The cells are evaluated for abnormalities, specifically for pre- cancerous and cancerous changes.
  • A woman may experience a small amount of spotting (light vaginal bleeding) immediately after a Pap smear, but heavy or excessive bleeding is not normal.
  • Cervical cancer screening is recommended every 3 years for women aged 21-65.
  • The Pap smear is analyzed according to a uniform standardized system known as the Bethesda System.
  • An abnormal Pap smear may show precancerous changes that can be treated at an early stage, before cancer develops.
  • A recording of the woman's menstruation status and whether and when she had abnormal Pap smears previously is essential to the reader of the current Pap smear.
  • Up to 80% of women diagnosed with invasive cancer of the cervix have not had a Pap smear in the past 5 years.
  • Cancer of the cervix is largely a preventable disease.

What is a Pap smear procedure?

A Pap smear (Papanicolau smear; also known as the Pap test) is a screening test for cervical cancer. The test itself involves collection of a sample of cells from a woman's cervix (the end of the uterus that extends into the vagina) during a routine pelvic exam. The cells are placed on a glass slide and stained with a substance known as Papanicolau stain. The stained cells are then examined under a microscope to look for pre-malignant (before-cancer) or malignant (cancer) changes.

A Pap smear is a simple, quick, and relatively painless screening test. Its specificity, which means its ability to avoid classifying a normal smear as abnormal (a "false positive" result), while very good, is not perfect. The sensitivity of a Pap smear, which means its ability to detect every single abnormality, while good, also is not perfect, and some "false negative" results (in which abnormalities are present but not detected by the test) will occur. Thus, a few women develop cervical cancer despite having regular Pap screening.

In the vast majority of cases, a Pap test does identify minor cellular abnormalities before they have had a chance to become malignant, and at a point when the condition is most easily treatable. The Pap smear is not intended to detect other forms of cancer such as those of the ovary, vagina, or uterus. Cancer of these organs may be discovered during the course of the gynecologic (pelvic) exam, which usually is done at the same time as the Pap smear.

Medically Reviewed by a Doctor on 1/6/2016
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