Pap smears are screening tests for cervical cancer in which a swab introduced into the vagina is used to collect cell samples. Pap smears have been instrumental in decreasing the number of cases of cervical cancer in North America by detecting a precancerous condition called dysplasia.
Dysplasia is an alteration in the skin of the cervix, vagina, vulva or anus that has the potential to progress to cancer if left untreated. It usually doesn't cause any symptoms but sometimes can be associated with abnormal bleeding or spotting.
Pap smears are an excellent way to detect dysplasia of the cervix, which is the most common site for dysplasia in women. The test is the most effective form of cancer prevention available to women. It has recently been adapted as a screening test for the anus, to detect anal dysplasias and cancer. It is recommended that females, age 25 to 65, who have had sex get regular Pap smear tests. Guidelines on test frequency vary, from annually to every five years.
In North America, about 2-3 million abnormal Pap smear results are found each year. Sometimes, pap smears can be abnormal when there are no pre-cancerous conditions present. Some common types of abnormal pap smears are:
Once dysplasia has been detected on a pap smear, the genital area should be examined under magnification — a procedure known as colposcopy — to identify exactly where the dysplasia is located, followed by removal of the dysplasia if indicated.
There are a number of ways to remove the abnormal cells created by dysplasia. They include:
For other abnormal pap smears, the next step usually is to repeat the test. Sometimes, the practitioner will prescribe antibiotics or hormones, either oral or vaginal, before repeating the pap smear.