Pap Smear Test – Definition, Preparation, Accuracy

Pap Smear Test – Definition, Preparation, Accuracy

What Is A Pap test?

This is a question that many people ask. Named after Dr. George Papanicolau, this is an important test that is used to check if a woman has cervical cancer. When a Pap test is done, a speculum is gently inserted into the vagina to get a visual of the cervix. Then, some cells are scraped from this part, which is then applied to a glass slide and submitted to a laboratory to be analyzed.

What Type of Women Should Have Pap Tests?

According to a published 2013 national guideline for Cervical Cancer Screening, women who are sexually active are recommended to have regular Pap tests every three years starting at the age of 25 until they reach the age of 69. However, there is a specific protocol in every province and territory and you should always keep this in mind. Make sure that you check individual guidelines in every province and territory as there may be variations in the age and number of times that you should have Pap tests.

How To Prepare For A Pap Test?

For premenopausal women, the best time to get a Pap test done is during mid-cycle. You should remember not to try to get a Pap test done during your period because when there is blood on the slide, it will make the reading unreliable.

Also, if there is anything else that might interfere with the ability to get an accurate specimen from the cervix, such as cervical manipulation, intercourse, using vaginal medications, douching, spermicidal jellies and foams, etc. should be avoided 1 to 2 days before you get the test done.

Are Pap Tests Accurate?

As with all tests, the results of Pap tests are not 100% accurate.

There are chances that pap tests can fail to detect cancerous or precancerous changes. This test can also report if there are any changes taking place in the cervical cells.

It is vital to get regular Pap tests when you need to reduce the consequences of errors.

[Read: Interpretation OF Abnormal PAP Smear Test]

How Are Pap Tests Graded?

In order to understand the results of Pap tests, it is crucial to know that the cells lining the cervix and the ones that are scraped most often in this type of test are squamous cells and also that approximately 90% of cervical cancers that occur in these cells are squamous carcinomas. When there are cancerous glandular cells found on the inside of a cervix become cancerous, these types of cancer are known as adenocarcinomas.

Results that do not require you to get a follow-up are reported as benign cellular changes or within normal limits.

Overall, approximately 1 in 10 Pap tests have abnormal results, but in many cases, these are caused by inflammation and not by a cancerous or precancerous change.

There are different changes detected by this test that are dealt with through watchful waiting, treatment of any concurrent infection and repeating the Pap smear more frequently or colposcopy. A large number of milder changes eventually return to normal without the need for treatment.

For changes that are more advanced, therapy can consist of

  • Lasers
  • Cryosurgery (which involves freezing the cells)
  • A cone biopsy, during which a cone-shaped slice of tissue from the cervix is removed
  • Electric cautery
  • In selected cases, hysterectomy, if required

When Should Pap Tests Be Stopped?

It is highly important to note that the highest rate of deaths caused by cervical cancer involves women over 65, but they get Pap tests far less frequently than younger women because they are often reluctant to ask for this crucial screening test and also, physicians often do not make it a requirement for their older patients. If you have questions about getting a Pap test and pelvic examination, you should always ask your doctor.

According to the national guideline that was published in 2013, women who are over the age of 70 can stop doing Pap tests if their tests have had 3 negative results in a row over a period of 10 years. However, the guideline may be different in each area, so you should ask your doctor.

If you have had a hysterectomy, you do not need to get Pap tests on a routine basis, unless you have had cervical cancer. If this is the case, you should continue to get regular Pap tests in which your doctor takes scrapings from the vagina.

Pap tests are important which is why every woman should ask her doctor about it and get it on a regular basis. Your doctor can explain why it is essential to get the test and how you can detect and treat cervical cancer early with the right tests and examinations.

Medically Reviewed By
Dr. Sameer Kumar (MBBS, MS, FMAS, DMAS)Obstetrician & Gynecologist