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The Pap smear is a simple test to collect a small sample of cells from the cervix which helps to diagnose  precancerous and cancerous conditions of the cervix. It also aids in diagnosing infections and inflammation of the lower reproductive tract.

Who should get the Pap test done?

As per the International recommendations, the age of screening is 21 years. In our country due to low resources for screening, national recommendations are to start screening at 30 years of age.

Women who are 30 years and above should undergo a Pap test once in every 3 years until the age of 65 years. If this test is combined with HPV test, then the duration of screening can be increased to 5 years.

Women who do not routinely require Pap test

  • Women aged below 21 years and above 65 years
  • Women who have undergone hysterectomy for benign condition

When should the Pap test be done?

The Pap test, yields optimum results, if scheduled between 10 to 20 days of the menstrual cycle. The woman should not be menstruating at the time of test.

preparation

Preparation for Pap smear

Following should be avoided 48 hours before the test: 

  • Intercourse
  • Douching of vagina
  • Vaginal medications
  • Vaginal contraceptives like creams/ jellies 

Procedure

Procedure

An instrument called a speculum is gently introduced into the vagina and the cervix is visualized. There may be some discomfort or cramping during the procedure, but it is not usually painful.

  • A small wooden stick or spatula is used to gently scrape the surface of the lower part of the cervix to pick up cells.
  • A special brush, called a cytobrush is used to obtain cells from the inner part of the cervix.
  • The cells are placed on a glass slide, immediately fixed in a solution of alcohol and sent to laboratory for further processing and interpretation. 

Results of Pap test

Results of Pap test

A Pap test result may be reported as normal or abnormal. 

Normal Pap test

If the test report is normal, this means no abnormal or cancerous cells have been found in the smear taken.

Abnormal Pap tests

Abnormal Pap test results usually do not mean that the woman has cancer. Most often there is a small problem with the cervix. If results of the Pap test are unclear or show a mild abnormality in the cells of the cervix, your doctor may repeat the Pap test in 6 weeks, in 6 months or a year, or run more tests. Treating abnormal cells that don’t go away on their own can prevent almost all cases of cervical cancer. Treatment of this abnormality is often done in an out-patient department (OPD). If the test findings suggest more severe abnormality in the cells, it is confirmed by further  procedures:

  • Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas.
  • Biopsy: A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue (punch biopsy) is usually done in the OPD.

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