A Pap smear is a simple medical procedure for distinguishing normal from abnormal cells of the cervix, uterus and vagina. It is most accurate in detecting cervical abnormalities that may be precursors to cancer of the cervix.

The test was named after Dr. George Papanicolaou, who discovered the cancerous changes in the cervix and developed the test. During a pelvic exam, a physician inserts a cotton swab, a cervical brush or a wooden spatula into the vagina and gently rubs the cervix to remove some cells.

This procedure is not usually painful if done properly and even when it is mildly painful, the discomfort does not last long. The cells are studied under a microscope to look for the presence of abnormalities. A negative result means there were no abnormal cells found and no further action is necessary until the next Pap smear is due a year or two later.

Positive Pap Smear Doesn't Mean Cervical Cancer

A positive Pap smear means that abnormal cells were detected. However, this does not necessarily mean that a woman has cervical cancer. First of all, there are a fair number of false positive results with this test. That means that the test may read as positive, when in fact the cells are perfectly normal.

It is often advised that when results are positive, the test should be repeated to rule out the possibility of a false positive. Second, a positive Pap smear can be indicative of pre-cancerous or non-cancerous cell growth as well. Abnormal cell growth that is non-cancerous is termed dysplasia.

Most medical professionals refer to cervical dysplasia as "cervical intraepithelial neoplasia" (CIN). There can be varying degrees of severity of CIN, from CIN I (mild) to CIN III (severe). Classification is based on how much of the surface tissue is affected and on the kind and degree of cell changes that are found.

Most Cases of Cervical Dysplasia Are Mild

Most cases of CIN are mild, but if allowed to go unchecked and untreated, it can progress in severity and possibly change to cancer. This is why it is so important for women to have yearly Pap smears. Studies have found that the risk of developing cervical cancer is 3-10 times greater in women who have not been screened. Risk also increases when a long time lapses between tests.

In addition, survival from cervical cancer appears to be directly related to the stage of the disease at the time it is detected. Women diagnosed with early stage, localized cervical cancer were shown to have an 88 percent chance of surviving for at least 5 years. For those diagnosed with a more advanced stage of disease, the survival rate is only 13 percent.

Any abnormal cell growth needs to be examined more thoroughly to determine whether cancer is actually present. Follow-up procedures usually include colposcopy (a procedure that magnifies the area) and tissue biopsy.

Through colposcopy, the cervix can be viewed directly through a special microscope and a sample of the abnormal cells can be removed and sent to a lab for accurate diagnosis. The removal and analysis of the cell sample is called a tissue biopsy.

Pap Smear: An Annual Event

Screening for cervical abnormalities should begin in the late teens. A Pap smear should be done once a year as part of a routine gynecological check-up, or as often as your doctor advises. Some studies have found that screening every 2-3 years has been sufficient for women who have had several negative Pap smears in a row. Women who have had a positive Pap smear in the past may be advised to have the test repeated more frequently.

Copyright 2002 Sinclair Intimacy Institute