Why you need a Pap test
The Pap test is a critical part of your healthcare routine. The abnormalities detected by the Pap test are those that may lead to cancer. Early detection of these abnormalities can head off cancer and save your life.
"Nearly all deaths from cervical cancer can be prevented with routine Pap smears," says Dr. Matilde Parente, a female pathologist who's read thousands of Pap smears.
Pap test guidelines
It wasn't too long ago that women 18 and older were encouraged to have at least one Pap test per year. But in 2009, the American College of Obstetricians and Gynecologists (ACOG) created the following guidelines:
- Women should have their first Pap tests by age 21.
- Women ages 21 to 30 should be screened every two years.
- Women older than 30 who have had three consecutive normal Pap tests may be screened once every three years.
- Women with certain risk factors — such as HIV, previous cervical abnormalities or cancer — may require more frequent screening.
- Women over age 65 who've had no abnormal Pap tests in the last 10 years may, with a doctor's permission, stop having Pap tests altogether.
- Women who've had a hysterectomy do not need Pap tests unless the surgery was done as treatment for a cancerous (or precancerous) condition.
Preparing for your Pap
"A shower the morning or night before your Pap smear is adequate," advises Dr. Parente. "Do not use vaginal washes, foams, gels, douches or other chemicals before your appointment. Refrain from having sex for one or two days before your test, and schedule the Pap for when you are not having active menstrual bleeding."
How the Pap test is done
Paps are typically conducted in doctor's offices, clinics or hospitals by physicians (typically gynecologists), physician assistants, nurse practitioners or nurse midwives.
During the Pap, an instrument called a speculum is used to widen the vagina. The surface of the cervix is gently swabbed and the collected cells are placed onto a microscope slide for examination in a lab — hence the term "Pap smear."
The lab will examine the collected cells for abnormalities that may indicate pre-cancer, cancer, infection or inflammation.
Your results will be reported as "normal" ("negative") or "abnormal" ("positive"). According to the National Cancer Institute, about 6 percent of all Pap tests in the U.S. are abnormal and require follow-up care.
When the Pap test results are "abnormal"
Abnormal cells rarely become cancerous. Your doctor may perform another Pap test to compare to the original. Often, abnormal cells in the cervix go away without treatment.
Your doctor may do follow-up testing (a colposcopy) to examine your cervix and vagina further. If the colposcopy finds abnormalities, the doctor may take a biopsy of the area for examination. From there, she can determine the chance of those cells becoming cancerous and whether further treatment is needed.
Do your part
Rather than looking at your Pap test as dreadful, view it as empowering. You can prevent cervical cancer simply by showing up for your regular Pap smear and letting it all hang out...