PAP Smear

A Pap Smear is a medical procedure in which a sample of cells from a woman’s cervix is collected and smeared on a microscope slide. The cells are examined under a microscope in order to look for pre-malignant (before-cancer) or malignant (cancer) changes. It is a screening tool to find early warning signs that cancer might develop. If abnormal changes are found at screening, further tests will be done to see if treatment is needed.

A Pap Smear only takes a few minutes. No drugs or anaesthetics are required. The Pap Smear is not intended to detect other forms of cancer such as those of the ovary, vagina, or uterus. It is not a check for sexually transmitted infections. Cancer of these organs may be discovered during the course of the gynecologic (pelvic) exam, which usually is done at the same time as the Pap Smear.


What Are The Symptoms Of Cervical Cancer?

In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap Smear.

If you have any abnormal vaginal bleeding (intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your doctor.

Who Is At Risk?

All women with a cervix who have ever had sex at some time in their life are at risk of cervical cancer.

Which Women Are At Increased Risk For Having An Abnormal Pap Smear?

A number of risk factors have been identified for the development of cervical cancer and precancerous changes in the cervix.


  • HPV: The principal risk factor is infection with the genital wart virus, also called the human papillomavirus (HPV), although most women with HPV infection do not get cervical cancer. About 95%-100% of cervical cancers are related to HPV infection. Some women are more likely to have abnormal Pap Smears than other women.
  • Smoking: One common risk factor for premalignant and malignant changes in the cervix is smoking. Although smoking is associated with many different cancers, many women do not realize that smoking is strongly linked to cervical cancer. Smoking increased the risk of cervical cancer about two to four fold.
  • Weakened immune system: Women whose immune systems are weakened or have become weakened by medications (for example, those taken after an organ transplant) also have a higher risk of precancerous changes in the cervix.
  • Medications: Women whose mothers took the drug diethylstilbestrol (DES) during pregnancy also are at increased risk.

Other risk factors:

Other risk factors for precancerous changes in the cervix and an abnormal Pap testing include having multiple sexual partners and becoming sexually active at a young age.

What Is The Cause Of Cervical Cancer?

Human Papillomavirus (HPV), a sexually transmitted infection. The presence of HPV may be detected by the Pap Smear. Some women who have persistent infections may develop abnormalities of the cervix. This is why it is important to have a regular Pap Smears.

How Often Should I Have A Pap Smear?

All women who have ever had sex are advised to have a Pap Smear once a year, even if they no longer have sex and every 2 years if three normal tests in a row in women > 30 years old.

Your general practitioner may recommend more frequent Pap Smears if a previous Smear showed significant cell changes or you experience problems, such as bleeding or pain after sex.

I’ve Been Through Menopause; Do I Still Need To Have A Pap Smear?

Yes, the risk of getting cervical cancer is the same even after menopause so it is important to keep having Pap Smears every two years, even after menopause.

How Is A Pap Smear Done?

The best time to do Pap Smear screening is between 10 and 20 days after the first day of her menstrual period. For about two days before testing, a woman should avoid douching or using spermicidal foams, creams, or jellies or vaginal medicines (except as directed by a physician). These agents may wash away or hide any abnormal cervical cells.

  • With the woman laying on her back, the doctors will often first examine the outside of the patient’s genital and rectal areas, including the urethra, to assure that they look normal.
  • A speculum is then inserted into the vaginal area. A speculum is an instrument that allows the vagina and the cervix to be viewed and examined.
  • A small brush called a cervical brush is then inserted into the opening of the cervix and twirled around to collect a sample of cells.
  • The samples are gently smeared on a glass slide and a fixative (a preservative) is used to prepare the cells on the slide for laboratory evaluation.

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