Pap Tests

From Looking After Your Body

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Ever since the Papanicolaou (Pap) test -- a lab analysis of cells scraped from the cervix -- was developed, it has remained the standard way of detecting cervical cancer.

Who needs it The American Cancer Society, the National Cancer Institute, and other organizations recommend the following:

All women who are or who have been sexually active or who have a major risk factor for cervical cancer need a Pap test once a year.

If you're at low risk for cervical cancer and your last three annual Pap tests were normal, ask your doctor about having the exam less frequently.

If you've had a hysterectomy, ask your doctor if you still need a Pap test, and how often.

How it's done The gynecologist inserts a metal device called a speculum into the vagina, then passes a swab through it to obtain a sample of cells from the cervix and endocervical canal. The sample is spread on a glass slide and sent for analysis. New techniques are making the test more accurate. With ThinPrep, endorsed by the American College of Obstetricians and Gynecologists and reimbursed by most insurance companies, extraneous particles are filtered out of the specimen, making it easier for a lab technician to analyze cells. Also, a computerized system called PAPNET can detect microscopic abnormalities that technicians could miss. Some insurance companies don't reimburse for this technique, so check with your provider.

What the results mean If your Pap test comes back positive for abnormal cells, it doesn't necessarily signal cancer. Mild dysplasia, or early noncancerous cell changes confined to the thin layer of tissue that covers the cervix, sometimes progresses to cancer if left untreated, but often returns to normal. Severe dysplasia involves almost the full thickness of the epithelium and indicates late-stage precancerous cell changes. Either condition calls for close monitoring during more frequent checkups. If the test suggests a malignancy, your doctor will arrange for a colposcopy, a procedure that gives her a magnified view of your cervix and allows her to remove a sample of tissue for further analysis.

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