Everything You Should Know About The Pap Test

A Pap test, also called a Pap smear, is a simple and effective method for diagnosing cervical diseases. This test, developed by the Greek doctor Georgios Papanikolaou, is used in gynecology for the early detection of precancerous changes and cervical cancer. It has become an essential part of cervical cancer prevention and helps millions of women around the world prevent the development of this dangerous disease.

What is a Pap test?

A Pap test is a procedure in which a doctor takes samples of cells from the surface of the cervix to examine them under a microscope for abnormal changes. The test is performed on an outpatient basis and is usually part of a standard gynecological examination.

The main goal of a Pap test is to detect the early stages of cellular changes that can cause cervical cancer. Such changes are called cervical intraepithelial dysplasia or neoplasia (CIN). The earlier these changes are detected, the easier and more effective it is to treat them and thus prevent the development of cancer.

How is a Pap test performed?

Taking a Pap smear is a relatively simple procedure. The doctor uses a special instrument called a speculum to access the cervix. A cell sample is then taken from the surface of the cervix and cervical canal using a brush or spatula. The procedure usually takes a few minutes and requires no special preparation from the patient.

Although the test itself may cause discomfort, many women don’t experience much pain. However, some people may experience mild cramping or pressure in the pelvic area. Once the procedure is complete, the cell samples are sent to a laboratory for analysis.

Who needs a Pap test and how often?

Recommendations for Pap test frequency may vary based on age, medical history, and other factors. General recommendations are:

- Women aged 21 to 29: It is recommended to have a Pap test every three years if previous results were normal.

- Women aged 30 to 65: A combined test (Pap test and human papillomavirus (HPV) test) may be offered at this time. If both tests are negative, the test can be repeated every five years. If only one Pap test is performed, it is recommended that it be performed every three years.

- Women over 65: If a woman has had several normal test results in the past 10 years and is not at risk, additional Pap tests may not be necessary.

In addition, doctors may recommend more frequent testing for women with certain risk factors, such as a weakened immune system, a positive HPV test, or a history of abnormal Pap tests.

Pap test results

Once the cell samples are sent to the lab, they are analyzed under a microscope to look for abnormal changes. The test results may look like this:

- Normal result: If the cells appear normal, this means that no changes were detected in the cells of the cervix at that time and no further testing is needed until the next routine test.

- Abnormal result: An abnormal Pap test result does not always mean that cancer is present. In most cases, it indicates the presence of abnormal cells that may be caused by infection, inflammation, or precancerous changes. In these cases, additional tests may be ordered, such as a colposcopy (examination of the cervix under magnification) or a biopsy (removal of a small piece of tissue for examination).

Pap test and human papillomavirus (HPV)

One of the main factors associated with the development of cervical cancer is infection with the human papillomavirus (HPV). HPV is a common sexually transmitted infection that often goes away on its own, but in some cases can cause precancerous changes in the cells of the cervix.

There are now tests that can detect HPV and assess the risk of developing cervical cancer. These tests are often done in conjunction with a Pap test in women over 30 because at this age the likelihood of HPV self-healing decreases and the risk of dysplasia increases. If high-risk HPV is detected (e.g., types 16 and 18), women may be offered additional tests to rule out the presence of precancerous changes.