The pap test
A pap test is part of a routine pelvic exam. A pap
test is not a diagnostic tool, but a screening to check
for cervical cell changes. A pap test is also currently
the only screening available in the world for cervical
cancer.
During the pelvic exam, the gynecologist will use a
swab to collect a sample from a woman’s cervix.
The sample is then placed on a slide and checked by
a lab for abnormalities. Pap tests are virtually painless
and take no more then five minutes to perform. Women
should abstain from sexual intercourse, vaginal medication
and douches prior to having a pap test.
It usually takes several weeks for your results to
come back. If your doctor says that your pap test was
abnormal, this does not mean that you have cervical
cancer.
What does an abnormal pap test mean?
There are many factors that can cause abnormal Pap
test results. Many times, abnormal cell changes occur
due to several types of the HPV
virus. HPV is the most common sexually
transmitted disease in the world. Most strains of HPV
clear up without any treatment. Certain strains of HPV
have been linked to cervical cancer and this is why
routine pelvic exams/pap tests are important.
HPV is the most common cause of abnormal Pap test results.
If HPV is suspected, a doctor may choose to perform
the HPV DNA test.
Most laboratories in the United States use the Bethesda
System to describe the results of the Pap test. Using
one uniform system to describe Pap test results helps
aide doctors in choosing the most appropriate course
of action for treatment, if required.
If a Pap test returns normal, this means that the cervix
was negative of cell changes. Women who receive normal
findings are generally told to repeat the Pap test in
another year.
Atypical Squamous Cells or ASC indicates that some
abnormal cervical cell changes were seen. With ASC,
a doctor may want to repeat the Pap test or conduct
further testing.
Squamous Intraepithelial Lesion or SIL indicates that
changes in the cervix were seen that may indicate pre-cancer.
SIL is then broken into two degrees. LSIL-Low grade
Squamous Intraepithelial Lesion indicates mild changes.
HSIL-High grade Squamous Intraepithelial Lesion indicates
moderate to severe changes.
It is important for women to be upfront and honest
with their doctors, no matter how embarrassing it may
be, when it comes to their health history. A woman’s
history, including risk factors, is taken into consideration
when planning treatment for abnormal Pap test results.
Women who smoke are at an increased risk for pre-malignant
and malignant (cancerous) changes in the cervix. You
should tell your doctor if you smoke or have smoked
in the past.
Becoming sexually active at a young age and females
who have had multiple sex partners are at an increased
risk. A woman who has had only had one partner, but
whose partner has had multiple partners, is at an increased
risk. Women whose immune systems are compromised due
to diseases or medications are also at a higher risk
for cervical cell changes.
Depending on a woman’s current health status,
Pap results and health history, a doctor may order various
treatments.
Many doctors choose to perform a colposcopy. A colposcopy
is performed using a colposcope. The vagina is prepped
with a solution which will make abnormal cells more
easily visible. A colposcope is placed inside the vagina.
If abnormal tissue is seen, a sample or biopsy will
be taken and sent to a lab for analysis.
If a doctor can not visualize the cervix with the colposcope,
another method to obtain cervical tissue is called conization
or more commonly known as a “cone biopsy.”
This method is more invasive as it requires a woman
to use anesthesia and there is a longer recovery period.
A cone shaped sample is removed from the cervix and
sent to a lab for testing.
When a woman has a confirmed diagnosis that requires
treatment, several procedures are available. Doctors
generally choose the least invasive procedure available.
Depending on the severity of the cells, a doctor may
choose to kill the abnormal cells by means of freezing,
burning or removing them with a laser.
With the simple, painless screening tool available,
and the chances of developing cervical cancer low, perhaps
you’re wondering how so many women die every year
from cervical cancer. Cervical cancer is a preventable
disease. Most women who are diagnosed with aggressive
forms of cervical cancer have never had a Pap test performed
or did not have them routinely done.
For many women, the cost of regular doctor visits and
thus, routine Pap tests, are a hurdle. In the United
States, The National Breast and Cervical Cancer Early
Detection Program is a federally funded program for
uninsured women. The CDC’s website provides the
information needed to find a local program. NBCCEDP
The following information is provided for educational
purposes only and should in no way be used to diagnose
or treat a condition. As always, you should direct any
questions you may have to your doctor.
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