The test used to detect cervical cancer is called a Pap test, named for Dr. George Papanicolaou. The Pap test detects changes in the cervix that could be a sign of cancer or precancer (changes that could lead to cancer.) It is a screening test. The Pap test detects possible signs of disease in women who do not have symptoms such as bleeding, pelvic pain, or discharge.
The Pap test has been very successful in decreasing deaths from cervical cancer. Before a woman gets cervical cancer, she may go through several stages of pre-cancer. This usually happens over a number of years. Because the precancer cells are right on the surface of the cervix, the Pap test can pick up precancer before cancer grows. If abnormal cells are found, they often can be treated with simple procedures in the doctor's office.
This web page will explain how the Pap test is performed, and how the test results are studied, classified, and reported.
A Regular Part of Your Health Care
Some women are at increased risk for developing cervical changes. You may be at increased risk if any of the following applies to you:
If you have any of the above risk factors, it is even more important for you to have a Pap test each year.
If you have no risk factors, and have had three normal tests in a row, you may be able to have the test done less often. Less frequent testing should be based on your doctor's advice. It only applies if your risk factors don't change. Even if your doctor decides you don't need a Pap test every year, you should still see your doctor each year for a pelvic exam.
The cervix is covered by a thin layer of tissue like your skin. The cells that make up this tissue grow all the time. During this growth, the cells at the bottom layer slowly move to the surface of the cervix. When these cells reach the surface, they are shed as a normal process.
When this normal process is changed in some way, cells become abnormal. Sometimes the abnormal cells can lead to cancer.
The Pap Test
During your pelvic exam, your doctor will insert a speculum into your vagina. This instrument gently opens the vagina so the cervix can be seen. A small brush or swab and scraper are used to remove cells from the cervix. This is not painful. Cells will be taken from inside the opening of the cervix and from the outer part of the cervix. They are sent to a lab to be tested. A specially trained technician or doctor looks for cells that do not appear normal. The results are classified based on how the cells look. Your doctor is then informed of the results.
Is the Pap Test Always Accurate?
False-negative results are reports of normal test results when there are abnormal changes. This occurs in 10-20% of all Pap tests.
False-negative results can occur for a number of reasons:
False-positive results can also occur. This means that abnormal cells were reported but the cells were really normal. This is rare.
Any abnormal finding or a finding of ASCUS showing that cells may not be normal requires further tests. This may be a simple as a repeat Pap test in a few weeks or months. Sometimes your doctor will do an exam called a colposcopy to decide if you need treatment. Colposcopy is done in your doctor's office with a special microscope called a colposcope. By looking at the cervix through a colposcope, your doctor may be able to see the changes that cause the abnormal Pap test result.
Colposcopy may help the doctor decide whether a cervical biopsy needs to be done and if so, what kinds. (In some cases, a doctor may do a biopsy even if nothing is seen on colposcopy.) A biopsy removes some of the abnormal cells for further study. It is usually done in the doctor's office or clinic. It may cause slight discomfort for a few seconds.
There are several types of biopsies. Your doctor may perform one of the following:
One method of treatment is cryotherapy. Cryotherapy is an office procedure used to treat abnormal cells on the cervix. It is usually done during the first week after a menstrual period. It takes only a few minutes, so you should be in and out in less than an hour. During cryotherapy, the abnormal tissue is frozen. This tissue dies, and the tissue that grows back is most often normal. There is no cutting or bleeding. You may be given medication to take ahead of time to relieve any cramping you might feel during the treatment.
And In Conclusion...
See your doctor once a year for a pelvic exam. For most women, this visit will include a Pap test. Be sure to see your doctor right away if you notice abnormal vaginal spotting, bleeding or discharge. These are signs that something might be wrong.
If you do have an abnormal Pap test, do not panic. Follow your doctor's advice. Only a small number of women with abnormal Pap test results have invasive cancer. Thanks in part to the Pap test, deaths from cervical cancer have decreased over the last 40 years. However, the rate of abnormal cells found in Pap tests in young women is rising. This means that the Pap test is more important than ever to prevent an increase in cervical cancer. By understanding the Pap test and how results are reported, you can take an active part in your health care.