Pap Test - (Pap Smear, Pap Screening, Papanicolaou Test)

Pap Test: A diagnostic test of a sampling of cells from the surface of a woman's cervix to check for abnormalities that can develop into cancer

Parts of the Body Involved

Vagina
Cervix (the lower, narrow end of a woman's uterus)

Reasons for Procedure

To check cervical cells for:

Changes or abnormalities (cervical dysplasia) that could develop into cancer
Infection or inflammation of the cervix

Cervical cancer develops relatively slowly, so abnormalities detected early can be treated before cancer develops.

Risk Factors for Complications During the Procedure: None

What to Expect Prior to Procedure:

Do not schedule the Pap test during your menstrual period; if possible, schedule it two weeks after the first day of your period.
Do not use vaginal creams, medications, or douches for 72 hours before the test.
Do not use contraceptives such as spermicidal foams, creams, or jellies for 72 hours before the test.
Do not have intercourse for 24 hours before the test.

Tell your doctor if you:

Are having your period
Are pregnant
Had a previous Pap test showing abnormalities
Are sexually active
Have been exposed to HPV or other sexually-transmitted diseases
Have had abnormal vaginal discharges or vaginal infections
Have had surgery, radiation treatment, or chemotherapy
Are taking birth control pills, hormone pills, or using hormone cream

During Procedure

A Pap test is typically done as part of a pelvic exam.

Anesthesia

There is no anesthesia associated with this procedure.

Description of the Procedure

You lie on your back on an examination table, with legs spread and feet placed in foot rests. A medical instrument, called a speculum, is gently inserted into the vagina, and opened so that the doctor can take a sample from the cervix. A wooden swab, brush, or stick is inserted into the vagina and used to wipe the walls of the cervix to retrieve cervical cells. The speculum is removed, and the cervical cells are placed in a fluid-filled bottle, or on a glass microscope slide and sent to a laboratory for testing and evaluation.

After Procedure: After the speculum is removed, a pelvic exam is done. For this exam, the doctor checks the uterus, vagina, fallopian tubes, rectum, and bladder for irregularities.

How Long Will It Take?: The pelvic exam takes less than five minutes; the Pap test portion takes less than two minutes.

Will It Hurt?: A Pap test is generally painless, although you may feel some pressure or a small cramp when the cervix is wiped to acquire cells for examination.

Possible Complications: There are no known complications.

Average Hospital Stay: None...a Pap test is done at your doctor's office as part of a pelvic exam.

Outcome

Results of your Pap test are sent to your doctor within 2 to 3 weeks. Your doctor will then inform you of the results, and, if necessary, discuss any follow-up testing or treatment:

If cells are normal, no treatment is necessary. Have another Pap test with your next yearly pelvic exam.
If an infection is found, treatment will be prescribed.
If abnormalities are found, further tests will be performed. Once the cause of the abnormality is determined, your doctor will discuss treatment options with you. Further tests include:
- Colposcopy —examination of the vagina and cervix with an endoscope, a fiberoptic tube attached to a viewing device
- Biopsy —removal of a small amount of cervical tissue for further testing

Call Your Doctor If Any of the Following Occurs

Signs of infection, including fever and chills
Vaginal bleeding between menstrual periods or after menopause
Bleeding after intercourse
Foul vaginal odor, pain, or unusual vaginal discharge
Severe abdominal pain or swelling

RESOURCES:

American College of Obstetricians and Gynecologists
www.acog.org

National Women's Health Information Center
www.4woman.gov

CANADIAN RESOURCES:

Women's Health Matters
www.womenshealthmatters.ca/index.cfm