The Pap smear is a way to find changes of the cervix that may be very small (microscopic). If a Pap smear shows these changes, the result will be called abnormal or atypical. In some cases, after many years, abnormal areas on the cervix can become cancer, but most abnormalities of the cervix return to normal and do not become cancer.
All women who have been sexually active for 3 years or who have reached age 21 need to have regular Pap smears. The Pap smear is the only screening test for cancer which has caused a decrease in occurrences and deaths from cancer.
A Pap smear is a screening tool, not a diagnostic test; this means further testing is usually required when abnormal changes on the cervix are detected. The Pap smear alone cannot tell us exactly what is wrong. When the results of a Pap smear are abnormal, a colposcopy of the cervix is usually recommended. This is a quick procedure performed in a physician’s office. The physician uses a special microscope to look at the cervix and may take biopsies of abnormal appearing areas of the cervix.
A normal Pap smear is not a guarantee there is no cancer anywhere; it does not detect cancers of the uterus, fallopian tubes, or ovaries. Pap smears are just to look for abnormal or precancerous cells of the cervix which is just the opening to the uterus (womb).
Once you have had your first Pap smear, your physician will determine when you should have your next Pap smear, based on your history, the results of your Pap smear, the type of Pap smear that was performed, your age and if you had another test called the HPV test. Repeat Pap smears are commonly performed between 6 months and 3 and 5 years. This frequency may change depending on previous results, age or underlying medical conditions.
Abnormal Pap smear results are sometimes explained by an infection or inflammation. Yeast infections, herpes, trichomonas, recent sexual activity, or use of vaginal preparations are some of the many things which can cause an abnormal Pap smear result. Most commonly the culprit is HPV or human papilloma virus. HPV is a common infection. Up to 60% of sexually- active women may carry this virus on their cervix, genital area, or skin, but most are completely unaware of it. HPV of the cervix or other parts of the genital area is acquired through sexual contact. HPV usually goes away on its own without treatment, but when it causes severe changes to the cells of the cervix, treatment is necessary to prevent progression to cancer. Usually this treatment can be performed painlessly in a physician’s office. There is also a vaccine available to help protect against HPV infection and cervical cancer, reducing the risk by up to 99%.
Advanced Reproductive Medicine & Gynecology of Hawaii
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