The pap smear test or Papanicolau test is a test of the cells of the cervix and endocervix, done to detect any pre-malignant or malignant changes of the cervix. This would help in the detection of cervical cancer at an early stage. Detection of a cancer at an early stage would help in the better management of the patient and may lead to increased chances of survival.

How is Pap test done?

A pap test is usually performed by a Gynaecologist. The patient is placed in Sim’s position, with both legs separated and raised. This position enables easy insertion of the speculum into the vagina. The cervix is identified. Using a wooden spatula, the inside of the cervix is scraped. A brush is inserted into the cervix and a brushing of the inside of the cervix is taken as well. These samples are put in a preservative and sent to the lab for microscopic examination.

Is the procedure painful?

Pap test is not painful. But there might be slight discomfort because of the position and because of the feeling of the speculum inside the vagina. There might be slight bleeding after the procedure, but would subside soon.

What are the possible results of Pap test?

Pap test aims at finding any precancerous or cancerous changes in the cervix. The potential pre cancerous changes are cervical intraepithelial neoplasia or cervical dysplasia. The abnormal changes are usually caused by human papilloma virus which is the common cause of sexually transmitted diseases.

The abnormal results usually seen are

1. atypical glandular cells.
2. atypical squamous cells of undetermined significance.
3. low grade squamous intraepithelial lesion.
4. high grade squamous intraepithelial lesion.
5. squamous cell carcinoma.

Is it necessary to have a pap test?

For every sexually active woman, it is better to have a pap test as soon as she becomes sexually active. And it is advised for a sexually active woman who has not had a pap test to have the test done immediately after 35 years, at least once a year.

Are there any risks of a pap smear test?

There is no risk of pap test.

Are there any precautions to be followed before the test?

If you are scheduled to have a pap smear, you should avoid the following for the previous 24 hours.

1. douching.
2. intercourse.
3. tub bath.
4. tampons.

You should intimate the physician of the following.

1. suspected pregnancy.
2. previous history of papsmear- normal or abnormal.
3. intake of medications including oral contraceptive pills.

Any abnormal changes detected would be investigated further to diagnose cancer and manage effectively.