Pap Test (Pap Smear)


The simple, in-office screening procedure is used to identify the presence of abnormal cells on the cervix (the opening of the uterus). The Pap test can be used to detect precancerous cells and cervical cancer. It takes only a few minutes to perform.

The Procedure

In preparation for the procedure, the patient is positioned and a speculum is inserted into the vagina to expose the cervix. The physician carefully inserts a specialized collection device into the vagina. Many types of collection devices are available, including swabs, brushes, and spatulas. The physician collects a cell sample from the exterior of the cervix and from the entrance of the cervical endometrial canal. This is usually painless for most women, but in some cases it can be uncomfortable.

End of Procedure

When the procedure is complete, the speculum is removed and the patient is allowed to go home. The cell samples are sent to a lab for microscopic analysis. The physician will follow up with lab results.

Lab Results

The Pap smear will return with either a negative or a positive result. A negative result (also called a normal Pap) means that cells were successfully gathered but no abnormal cells were seen. A positive result (also called an abnormal Pap) means that abnormal cells were found. A positive result does not necessarily mean that the patient has cancer - the test may have detected atypical or suspicious cells that are not cancerous, but in some cases these cells may become cancerous if not treated. Sometimes, the Pap may also show evidence of an infection such as yeast, bacterial vaginosis, or human papilloma virus (HPV).

After a Positive Result

If a patient receives a positive result, the physician may repeat the test to rule out a false positive. If the second test confirms the positive result, the physician will recommend further testing and possibly treatment based on a combination of the patient's history and test results. The recommendations may include more frequent Pap tests or a colposcopy (a visual examination of the cervix performed with a lighted, magnifying viewing instrument called a colposcope). The physician may also take a tissue biopsy from the cervix or the endocervical canal and send these samples to the lab for further study.