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Pap test

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What is a Pap test?

The Papanicolaou test, more popularly known as the Pap test or the Pap smear test is an important screening test for women. It looks for changes in the cells at the cervix, i.e., lower portion of the uterus, that are a precursor to cervical cancer.

Why is it conducted?

Cervical cancer is a slow developing disease that can be cured when detected early enough. The Pap test can detect abnormal cells in the cervix before they become cancerous, thus making timely intervention possible.   

Who should go for it?

It is generally advisable for women from the age of 21 or a few years after they become sexually active. But it is especially important in the following situations.

  • If the woman has had multiple sex partners, then the chances of an HPV infection are increased. Some strains of this virus have been implicated in cervical cancer.
  • If the previous Pap test has detected the presence of abnormal cells, then it is advisable to have this test yearly.
  • Women who experience bleeding after intercourse or pain during intercourse are often ordered this test.
  • Women whose immune system is compromised either due to illness or due to medicines.
  • Women with normal pap test results should still have pap smears done every 3 years as minor changes can be missed sometimes.

Women whose uterus and cervix has been removed surgically do not need to have pap tests.


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The patient lies down on the examination table and a speculum is inserted in the vagina. This allows access to the cervix and a spatula or brush is used to scrape off cells from the cervix. These cells are then sent to the laboratory for testing. Though there may be some discomfort, it is more like menstrual cramps. A little bleeding or spotting is to be expected after the procedure. One should empty the bladder before the procedure begins.

Certain precautions need to be taken for the test results to be accurate.

  • A Pap test should not be scheduled during menstruation.
  • Avoid intercourse 24 hours prior to the procedure.
  • Avoid douching or using vaginal creams or suppositories prior to the test.
  • Do not use tampons.

Interpretation of results

Results are generally available after one week. A normal result means that no abnormal cells were observed. It is important to remember that the presence of abnormal cells does not necessarily point towards cancer. Abnormal test results may be reported as following:

  • ASCUS, atypical cells of undetermined significance, points towards changes in the cells that are not due to cancer. It is more likely due to inflammation or infection, especially in older women. In young women it has more chances of being due to an HPV infection.
  • LSIL, low-grade dysplasia or squamous intraepithelial lesion, means that there are changes which can lead to cancer. It is customary to advise a yearly or 6-monthly pap smear after this as it may either progress to HSIL or go away on its own without intervention.
  • HSIL, high-grade dysplasia or squamous intraepithelial lesion, means that the probability of developing cancer is high.
  • CIS, Carcinoma in situ, means that cancerous cells have been found only on the surface layer.

If the results show abnormal cells, proper follow-up is essential so that the risk of cervical cancer is minimized.

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Written by: Nandita tripati

Date last updated: January 10, 2015