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Gynecologic Health Gynecologic Screening

All About Pap Smears


Medically Reviewed On: August 23, 2001

Since the introduction of the Pap examination, deaths associated with cervical cancer have decreased by seventy percent in the United States. But the disease still kills thousands of women each year, and most of these women have not received a Pap smear. Below, two medical experts discuss the role of regular Pap examinations in effective cancer prevention.

What is a Pap smear?
FLAVIA GOLDEN, MD: A Pap smear is a test that can be done by a physician, usually a gynecologist or an internist. It's an in-office procedure that can be done very quickly, to help in the detection of cervical cancer.

How does it work?
SHAWN BIGGERS, MD: We actually do the Pap smear when you come for an annual visit. It is done by placing a speculum in the vagina, locating the cervix, and then scraping a small layer of cells off the cervix and also the inner part of the cervix. We then place those cells on a slide, which is then sent off to the lab, and is analyzed by doctors or technicians at the lab.

Is a Pap smear painful?
FLAVIA GOLDEN, MD: I would say that the Pap smear, generally, in addition to being a very, very quick test, taking perhaps no more than a couple of minutes, is at worst a little bit uncomfortable.

How often should women be screened?
SHAWN BIGGERS, MD: I tell my patients that annual screening is necessary. It should be annually, usually starting at the age of 18, or when a patient first becomes sexually active. It should continue on an annual basis.

How long should a woman continue to get Pap smears? Should elderly women be tested?
SHAWN BIGGERS, MD: Absolutely. One misconception is that, after multiple normal Pap smears, you can consider yourself not at risk. There are a significant number of women who will develop cervical cancer in their fifties and sixties. There are certain cases where we may do screening less frequently. But even women who are in their fifties and sixties should be getting annual Pap smears.

Who can perform a Pap smear?
SHAWN BIGGERS, MD: Traditionally, your gynecologist performs it at the annual GYN exam. An internist will often perform the test. Nurse practitioners or physicians' assistants who are trained in the technique can do the Pap smear as well.

What does an abnormal Pap smear result mean?
SHAWN BIGGERS, MD: When we talk about abnormal Pap smears, we're generally not talking about Pap smears that show cervical cancer. They usually show slightly abnormal cells that tell us that we need to take a second look by doing some follow-up procedures.

We often pick up abnormalities that mean nothing, and often we miss some abnormalities.

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