In this Article

• What is a Pap smear?
• Who should have a Pap smear?
• Which women are at increased risk for having an abnormal Pap smear?
• How is a Pap smear done?
• What are the risks of having a Pap smear?
• How is a Pap smear read (analyzed)?
• What information is included on a Pap smear report?
• Why is a woman's menstrual status important for the Pap smear?
• Why is a woman's past Pap smear history pertinent?
• When might a Pap smear not be adequate for interpretation?
• How is the final Pap smear diagnosis made?
• What are the possible recommendations for follow-up after a Pap smear?
• What treatments are available if a Pap smear is abnormal?
• What is the follow-up after treatment for an abnormal Pap smear?
• What is the current status of human papilloma virus (HPV) testing?
• When should women start and stop having Pap smears, and how often should Pap smears be performed?
• What is the current status of the newer Pap smear technologies?
• With Pap smears so available, why are women still dying of cervical cancer?
• Historical note: Dr. Pap
• Pap Smear At A Glance
• Pap Smear Index

Pap Smear At A Glance

• A Pap smear is a simple, quick, and essentially painless screening test.
  
  
• Cells collected from a woman's cervix are spread on a microscope slide for examination.
  
  
• The cells are evaluated for abnormalities, specifically for pre- cancerous and cancerous changes.
  
  
• Pap smears are recommended for all women starting at age 21 years or within 3 years of becoming sexually active, whichever comes first.
  
  
• Most women over age 30 who have had reliable Pap screening with persistently normal results can be screened less often than yearly.
  
  
• Pap smears should not be performed in women who have had a total hysterectomy for benign conditions and had prior normal Pap smears.
  
  
• The Pap smear is read (analyzed) according to a uniform standardized system known as the Bethesda System.
  
  
• 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.
  
  
• Screening guidelines recommend that most women over 65-70 years old who have had regular Pap screening with negative results can stop having Pap tests, because abnormal Pap smears are very unusual in this setting.
  
  
• 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 a preventable disease.

Previous contributing author: Carolyn Crandall, MD, FACP

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