In its earliest stages, cervical cancer usually causes no symptoms. Irregular bleeding, bleeding or pain during sex, or vaginal discharge may be symptoms of more advanced disease. These symptoms don't necessarily mean you have cancer, but they should always be discussed with a health care professional.
Despite the Pap test's 50-year record as a safe and highly accurate screening tool for cervical cancer and precancerous abnormalities of the cervix, many women do not have regular Pap tests. In fact, as many as 35 percent of women between the ages of 15 to 44 forgo this vital screening, according to the Planned Parenthood Federation and the U.S. Centers for Disease Control and Prevention (CDC). And, in fact, half of all newly diagnosed women with cervical cancer have never had a Pap test, and 10 percent haven't been screened within the past five years.
A Pap test is a simple procedure: After a speculum (the standard device used to examine the cervix) is placed in the vagina, cells are skimmed from the surface of the cervix with a cotton swab then smeared onto a glass slide. Another sample is taken from the T-zone (or the transition-zone, the area of transition between cervical cells and uterus cells) with a tiny wooden or plastic spatula, or a tin brush. Newer techniques called "liquid-based" Pap tests may provide a higher degree of accuracy and reliability.
The cervix is the narrow neck of the uterus that opens into the vagina. For women who have had total hysterectomies, in which the cervix is removed, cells are taken from the walls of the vagina. Women who have had a hysterectomy should continue to have a Pap test every two to three years until age 65 or 70 if they had a history of high grade squamous intraepithelial lesions before they had the hysterectomy. After age 70, they can discontinue screening after three consecutive normal Pap tests.
The slide is delivered to a laboratory where a cytotechnologist (a lab professional who reviews your Pap test slides) and, when necessary, a pathologist (a health care professional who examines bodily tissue samples) examines the sample for any abnormalities. Each smear contains roughly 50,000 to 300,000 cells.
Though not infallible, when performed properly the Pap smear detects a significant majority of cervical cancers — usually in the early stages when the likelihood of a cure is greatest, according to the American Society of Clinical Pathologists.