Risk factors, Procedure and Preparation for Pap Test | Oncology

Pap Test

What is the Pap test?

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that’s at the top of your vagina.

During the routine procedure, cells from your cervix are gently scraped away and examined for abnormal growth. The procedure is done at your doctor’s office. It may be mildly uncomfortable, but doesn’t usually cause any long-term pain.

Why is the pap smear done?

Uterine cells are smeared to detect changes before they become cancerous. If you have cancer, finding it early will give you the best chance of fighting it. If you don’t, the early detection of cell changes can help prevent cancer from developing.

Women ages 21 to 65 should have a daily Pap test. How often you do this depends on your general health and whether or not you’ve had an abnormal smear in the past.

Who needs a pap test?

Current Guidelines The trusted source recommends that women get regular pap smears every three years starting at age 21. Some women have a higher risk of cancer or infections. You may need frequent tests:

  • You are HIV positive
  • You have a weakened immune system from chemotherapy or organ transplantation.
  • If you are over 30 years old and have not had abnormal Pap tests, ask your doctor once every five years if the test is combined with the detection of the human papillomavirus (HPV).
  • HPV is a virus that causes acne and increases the risk of cervical cancer. HPV types 16 and 18 are the main causes of cervical cancer. If you have HPV, you are at risk for cervical cancer.
  • Women over 65 with a history of normal Pap smear results may stop having the test in the future.
  • Regardless, you should have regular pap smears based on your age, regardless of your sexual activity status. This is because the HPV virus has been inactive for years and suddenly becomes active.

Who can consider stopping the pap test?

In some cases, a woman and her doctor may decide to end the Pap test, namely:

  • After total cervical surgery:  After all cervical surgery, that is, surgical removal of the uterus, including the uterus, ask your doctor if you need to continue having Pap tests.
  • If your cervical surgery is done for a non-cancer condition, such as cervical fibroids, you can stop regular smears.
  • If your uterus is due to a pre-existing or cancerous uterine condition, your doctor may recommend that you continue with a routine Pap smear.
  • Aging: Doctors generally agree that women should stop routine pop testing at age 65 if previous tests for cervical cancer are negative.
  • Discuss your options with your doctor and decide what is best for you based on your risk factors. If you are sexually active with multiple partners, your doctor may recommend that you continue with the pop test.

Risk factors

The Pap test is the safest way to get tested for cervical cancer. However, the pap smear is not foolproof. It is possible to get false-negative results, even if you have abnormal cells, the test does not indicate the abnormality.

A false negative result does not mean that a mistake was made. Factors that can lead to a false-negative result:

  • Inadequate cell collection
  • An abnormal number of cells
  • Blood or inflammatory cells hide abnormal cells.

Although abnormal cells are more likely to go unnoticed, time is on your side. Cervical cancer takes many years to develop. And if one test does not find abnormal cells, the next will most likely be done.

How often should I have a Pap test?

The test should be done every 3 years for people 21 to 65 years old. You can choose to have a Pap test for human papillomavirus (HPV) starting at age 30. If you do, you may be tested once every 5 years. HPV is the most common sexually transmitted infection (STI) and is associated with cervical cancer.

If you have some health problems, your doctor may recommend that you have frequent outbursts. Some of them are:

  • A Pap test that reveals cervical cancer or early cells
  • HIV infection
  • Immunosuppression from organ transplantation, chemotherapy, or chronic corticosteroid use
  • You were exposed to diethylstilbestrol (DES) before you were born.
  • Talk to your doctor if you have questions or problems. They will definitely let you know.

Preparation of pap test

You should not have a pap smear during your period. Excessive bleeding affects the accuracy of the test. If your exam is scheduled for that time of the month, ask your doctor if you can reschedule it.

To get the most accurate pap smear, doctors recommend taking the following steps, 48 ​​hours before testing.

  • Don’t have sex or use lubricants.
  • Do not use sprays or powders near the vagina.
  • Do not insert anything into the vagina, including tampons, medications, creams, and suppositories.
  • Do not clean the vagina with water, vinegar, or other liquid (douche).

What happens during a pap test?

Pap smears can be a bit uncomfortable, but the test is very quick. During the procedure, you stretch your legs out on the exam table, and your feet are called stirrups. Your doctor will slowly insert a device called a speculum into your vagina. This device keeps the vaginal walls open and provides access to the uterus.

Your doctor will remove a small sample of cells from your cervix. Here are some ways your doctor can take this sample:

  • Some use a tool similar to a spatula.
  • Some use a spatula and a brush.
  • Others use a tool called a cytobrush, which is a combination of a spatula and brush.
  • Most women experience a slight push and irritation during a brief scraping.
  • The sample of cells from your uterus is kept and sent to the laboratory to test for abnormal cells.

After the pap smear

  • After your pap smear, you can learn about your day without limits.
  • Depending on the type of pop test you are doing, your doctor will transfer the sample of cells collected from your uterus to a container that contains a special liquid for storage on a sample (liquid-based pap test) or glass slide (smear traditional pop).
  • The samples are transferred to a laboratory where they are examined under a microscope to look for symptoms in the cells that indicate cancer or a pre-existing condition.
  • After the test, you may feel mild discomfort or numbness from scratching. You may also experience very light vaginal bleeding immediately after the test. Inform your doctor if discomfort or bleeding persists after the day of the test.
  • Ask your doctor when to expect your test results.


A Pap smear will alert your doctor to the presence of suspicious cells that need further testing.

Normal results

If only normal cervical cells are found during your pop smear, it is said to have a negative result. You do not need further treatment or exam until your next Pap smear and pelvic exam.

Abnormal results

If abnormal or abnormal cells are found during your pop smear, you will get a positive result. A positive result does not mean that you have cervical cancer. A positive result depends on the type of cells found in your test.

Here are some rules your doctor can use and what your next step is:

  • Diversified squamous cells (ASCUS) of undetermined importance. Squamous cells are thin and flat and grow on a healthy cervical surface. In the case of ASCUS, the Pap test reveals slightly abnormal squamous cells, but the changes do not clearly indicate the presence of precursor cells.
  • With liquid-based tests, your doctor can re-evaluate the sample for the presence of certain types of viruses known to promote the development of cancer, such as human papillomavirus (HPV).
  • In the absence of high-risk viruses, the abnormal cells found as a result of the test are not of great concern. If there are viruses that cause concern, you may need more tests.
  • Squamous intraepithelial lesion. The term is used to indicate that cells taken from a Pap smear may be premature.
  • If the changes are low-grade, the size, shape, and other characteristics of the cells indicate that it takes several years for them to become cancerous.
  • If the changes are high-grade, the lesion is more likely to turn into cancer very quickly. Additional diagnostic tests are required.
  • Atypical gland cells. Glandular cells make mucus and grow at the beginning of your uterus and in your uterus. Heterogeneous gland cells may appear a bit abnormal, but it is not clear if they are cancerous.
  • More tests are needed to determine the origin of the abnormal cells and their importance.
  • Squamous cell carcinoma or adenocarcinoma cells. This result means that the cells collected for the pop smear look very abnormal, making it almost certain that the pathologist has cancer.
  • “Squamous cell cancer” refers to cancers that arise in cells on the flat surface of the vagina or uterus. “Adenocarcinoma” refers to cancers that arise in the glandular cells. If such cells are found, your doctor will recommend a quick evaluation.
  • If your Pap test is abnormal, your doctor may perform a procedure called colposcopy using a special loupe (colposcope) to examine the tissues of the uterus, vagina, and vulva.
  • Your doctor can take a biopsy of any abnormal areas. The tissue sample is sent to the laboratory for analysis and an accurate diagnosis.

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