Almost 60 years ago, George Papanicolaou, MD discovered that by studying cells taken from the cervix, he could diagnose cancer of the cervix. Following further information by other physicians, his results led to the use of Pap Smear (named after him) for the diagnosis of cervical cancer.
The mortality rate from cervical cancer has steadily declined over the past 40 years due largely to Pap Smear screening programs leading to early detection and treatment. About 20,000 women died each year from cancer of the cervix then. That number has consistently dropped to about 5,000 presently and probably less if more women get Pap Smears as often as suggested.
When Should a Woman be tested and How Often?
The initial Pap Smear should be done at age 18 for those who are not sexually active or at the onset of sexual relations.
Repeat yearly and if normal in those consecutive years, discuss with your doctor - less frequent testing may be indicated
Don't stop because you are a senior citizen, as the risk of invasive cervical cancer increases with age. Repeat smear every three years may be adequate
All high-risk women should have more frequent Pap Smears (see the text on gynecological cancers on the home page to know if you are at high risk). Also discuss your risk factor status with your doctor.
Who Performs the Test?
Your gynecologist, family physician, internist or any physician who is trained to do it.
Avoid sexual intercourse, vaginal medicines or douching two days before the test, as all of these may lead to wrong results.
The best time to do the test is anytime if you are post-menopausal or days 10-20 after the onset of your last menstrual cycle.
How is Pap Smear Performed?
The doctor using a fine brush takes cells from the cervix and smears them on a glass slide. This is sent to the lab where a pathologist examines it and makes the diagnosis. You may notice mild vaginal spotting, which usually clears within 24 hours.
Results of Pap Smear
Your doctor will usually tell you that the results are either negative or positive. Negative results mean no pre-cancerous or cancer cells are found. The pathologist may report inflammation, which should be treated and then the test can be repeated.
Sometimes there are mild abnormalities. Your doctor will decide with you to watchfully wait or do further tests like colposcopy with biopsy or in fact repeat the smear.
Note that there are new methods of doing the test like ThinPrep, PAPNET and Auto Pap.
The $1,000,000 Question
Have you had a Pap Smear in the last year? Or are you afraid of cancer - discuss your risk factor status and Pap Smear with your doctor - you may be surprised!