Also called a Pap test, a Pap smear is a diagnostic test primarily used to detect the presence of cancerous cells in or around the cervix, the opening of the uterus. It can also be used to detect changes that occur for reasons other than cancer. A Pap smear can be performed very quickly during a routine pelvic exam using a long-handled swab to gather cells for examination under a microscope.
For most women, Pap tests should be performed every three years beginning at age 21. Once a woman reaches her mid-60s, the frequency of testing can be reevaluated. In women with certain risk factors including a family history of cervical cancer, Pap tests may need to be performed more frequently.
Pap tests are performed during a pelvic exam using a long-handled cotton swab. During the exam, the vaginal canal is gently widened using a lubricated speculum and the swab is advanced through the vaginal canal to the cervix where it is used to gently wipe the surface of the cervix to collect a sample of cells. The contents of the swab are evaluated under a microscope to look for abnormal changes that could indicate cancer or other issues like infection with the human papillomavirus (HPV). Pap tests are painless and take just a few minutes to complete.
Abnormal test results can occur for different reasons, and having an abnormal result is not necessarily an indication of cancer. In fact, most abnormal Pap test results are caused by issues other than cancer, including HPV infection, hormonal fluctuations, and even yeast infections. If the test results are abnormal, an additional Pap test may be performed or another exam called colposcopy may be used to visually examine the area using a magnifying device called a colposcope. Small tissue samples (biopsies) also may be taken during a colposcopy, then sent to a lab for further evaluation.
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