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Medical Author:

Melissa Conrad Stöppler, MD

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.

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Medical Editor:

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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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
• Patient Comments: Pap Smear - Results
• Patient Comments: Pap Smear - Testing
• Find a local Obstetrician-Gynecologist in your town
• 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