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Everything
You Always Needed to Know about Pap smears and Didn't Know to Ask
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women do not obtain annual Pap tests. Many who do think that a normal Pap
test means that they are cancer free. Find out the truth NOW. |
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| Structure
of the Cervix |
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Before beginning the discussion
about Pap Smears, we need to look at the structure of the Cervic.
The cervix is the visible end
of the uterus in the vagina and can be easily seen when a speculum, an
instrument that allows visualization of the cervix, is inserted into the
vagina.
The outside of the cervix
and the vagina are covered by a layer of flat cells call squamous or skin-like
cells. The cervical canal has different cells called columnar or glandular
cells. The area where these two cell types meet is called the transformation
zone (squamo-columnar junction). This is the area where abnormal
cell growth is found. This are can be visible or high in the canal
of the cervix and invisible to the naked eye when using a speculum alone. |
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| What
is it? |
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| A Pap test is a simple,
effective screening for cervical cell abnormalities. In 1941, Dr.
George N. Papanicolaou saw cervical cancer cells in a vaginal smear.
By 1943, the original Pap test was developed and screened only for the
presence of cancer cells. Now abnormalities in the outer layer of the cervix
that can progress to cervical cancer, a common form of cancer in women
that is easily treated if diagnosed in the "pre-cancer" or early stages,
can be identified. With appropriate follow-up, many abnormal conditions
can be treated successfully before they develop into cervical cancer. |
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| How
Is It Done? |
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This is part of your routine
gynecological exam. The test should be painless and quick.
The cervix is the visible end of the uterus in the vagina and can be easily
seen when a speculum, an instrument that allows visualization of the cervix,
is inserted into the vagina.
 A
small wooden spatula is used to scrape cells from the top layer of the
cervix. The outside of the cervix and the vagina are covered by a
layer of flat cells call squamous or skin-like cells. These cells are scraped
off with the woodedn spatula. These are then spread on a glass microscope
slide.
Next a soft, tiny-bristled brush is used to collect cells from the inside
of the cervical canal called the endocervix. The cervical canal has
different cells called columnar or glandular cells. These are the
cells the brush scrapes off. These are also spread on a glass microscope
slide.
The area where these two cell types meet is called the transformation zone
(squamo-columnar junction). This is the area where abnormal
cell growth is found. This are can be visible or high in the canal
of the cervix and invisible to the naked eye when using a speculum alone.
If you have any pain when the doctor is scraping the cervix, always let
her know. This is a painless procedure when done correctly.
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 The
slide is sprayed with a solution to keep the cells from drying and the
slide is then sent to a laboratory where trained technicians, called cytotechnicians,
examine the slide under a microscope. |
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| Who
Should Have One? |
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| All women who are or have
been sexually active should have a Pap test. Every woman should have a
Pap Test yearly starting with sexual activity, or upon reaching the age
of eighteen. If you are not and never have been sexually active,
you can have a test done every three years. However, if you are or
have been sexually active, you should have one done at least yearly as
part of your yearly GYN exam. Because it may interfere with the results
of the test, a Pap test cannot be done if you are on your menstrual period
or have a vaginal infection. |
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women do not obtain annual Pap tests. Many who do think that a normal Pap
test means that they are cancer free. The Pap test evaluates only
the squamous epithelium covering the visible part of the cervix. The endocervical
canal has a glandular epithelium that is not easily evaluated by Pap tests.
This glandular epithelium can also become malignant and not be detected.
Cancers of the uterus, ovaries and fallopian tubes are not usually detected
by the Pap test. |
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| What
are the Possible Results? |
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REPORTING SYSTEMS
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| This is the older method
of reporting Pap Smear results. It is still in use by some laboratories,
but most now use the Bethesda System (following chart) which is more descriptive
and gives the care giver more information about the Pap Smear. |
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OLD
REPORTING SYSTEM
| RESULTS |
MEANING
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| Class I |
Normal |
| Class II |
Atypical, inflammation
or uterine cells seen |
| Class III |
Dysplastic, mild, moderate
or severe |
| Class IV |
Carcinoma-in-situ |
| Class V |
Suspicious for an invasive
cancer |
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| The Bethesda System gives
the care giver much more information than the older, Class System does.
It tells whether or not the smear is adequate, contains cells from the
cervical canal, and explains what the person saw who read the slide. |
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RESULTS
REPORTED WITH BETHESDA SYSTEM
Adequacy
Satisfactory
Limited
Unsatisfactory |
Descriptive
Normal
Benign
Epithelial
cell abnormality
Inflammation
Atypical squamous cells of unknown significance (ASCUS)
Low grade squamous intraepithelial lesion (LSIL)
High grade squamous intraepithelial lesion
Glandular
cell abnormality
Atypical glandular cells (AGUS)
Adenocarcinoma |
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| How
to Prepare for Your Pap Test |
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The following are simple
Guidelines that may help insure a truer result from your test:
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Try to schedule your pap smear
the first two weeks after your period
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Avoid using things in your
vagina - such as tampons, sponges, and diaphragms
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Avoid intercourse for 48 hours
before your test
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Do not douche for at least
48 hours before your test
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Do not use bubble bath or oil
in bathwater prior to your test
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