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.
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.
A Pap smear is a simple, quick, and
essentially painless screening test (procedure) for cancer or precancer of the uterine
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
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
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.