A Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix, or the "mouth" of the womb (located at the top of the vagina), for the presence of:
A Pap test, along with a pelvic examination, is an important part of a female's routine health care because it may detect abnormalities that can lead to invasive cancer. Most invasive cancers of the cervix can be detected early if females have Pap tests and pelvic examinations regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early.
But, the Pap test is not only useful in detecting cancerous cells, it can detect other changes in the cervix and vagina, including dysplasia, or pre-cancer cells. Inflammation in the cervical area may also be detected. Inflammation may be caused by:
A woman should always consult with her physician about when and how often a Pap test and pelvic examination should be performed.
According to the National Cancer Institute (NCI), the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG), general guidelines include:
In the past few years, a newer way of testing cervical cells for abnormalities has gained acceptance in the medical community. This procedure is called liquid-based cytology. Approved by the US Food and Drug Administration (FDA), the test is a liquid-based procedure in which cells from the cervix are put into a vial of liquid instead of being "smeared" onto a slide. The liquid is then filtered and only the cervical cells are placed onto a slide for examination. Though the cost of the procedure, called Thinprep, AutoCyte, or SurePath, is double what a Pap test costs, studies show that these tests may require fewer repeat tests and detect more early-stage lesions. Consult your physician for more information.
When abnormal cells are identified on a Pap test, additional testing is generally recommended in order to determine if the abnormality requires treatment. However, a 2006 report from the American College of Obstetricians and Gynecologists (ACOG) recommends that abnormal Pap test results in adolescents may be managed somewhat differently.
Most cervical lesions of a lower grade will go away without treatment in adolescents. Thus, ACOG's current recommendation is to repeat the Pap test at 6- or 12-month intervals for a year after the original abnormal Pap test, depending on the individual situation of the adolescent involved. However, the plan of action for further testing and treatment after abnormal results from a Pap test will depend on the type of abnormality found and the adolescent's general health status.
Because certain strains of HPV have been found to cause most cases of cervical cancer, research efforts have focused on developing a vaccine against HPV. Two HPV vaccines have been developed, and clinical trials of these vaccines have been successful.
One of the vaccines, Gardasil®, was approved by the US Food and Drug Administration in 2006 and can protect women from HPV infections. It protects against four types of the HPV virus, including the two viruses that cause 90 percent of genital warts. Gardasil can only be used to prevent HPV infection before an abnormal pap test develops.
Gardasil is administered as a series of three injections over a six month period. Recommendations for giving this vaccine are still being discussed but many professionals feel the vaccine should be given to girls before they become sexually active.