A pap smear is a test done for cervical cancer screening. The cervix is covered with squamous cells. The pap test is a study of the changes in these cells.
HPV infection is the commonest cause of cervical cancer.
There are many types of HPV virus types but type 16 and 18 are the most important causes of cervical cancer.
When to do a Pap Smear Test?
One should start doing a pap test from the age of 21 and do every 3 years until the age of 65. After the age of 30, If the pap test is combined with an HPV test then one can do the test every 5 years.
The Procedure
Pap test is done during a routine outpatient examination. It is best done in the week after the period but can be done at any time of the cycle except during the period.
During a pelvic examination, a swab is taken from the cervix in order to collect the cervical cells for examination. The swab is then transferred to a small bottle containing a fixative liquid and sent to the laboratory for a check.
The Report
The report takes a few days and it will inform if the cells are normal or not. In case they are normal then there is no further action required until the next pap test is due.
In case the cells are not normal, the report will classify the changes.
The report for pap test may be as follows in case there are changes in the cells.
Atypical squamous cell of undetermined significance (ASC-US) – This suggests that there are changes in the cervical cells. It is the commonest abnormality seen in the reports. The changes are almost always a sign of an HPV infection.
Low-grade squamous intraepithelial lesion (LSIL) – the cervical cells show changes that are mildly abnormal.
High-grade squamous intraepithelial lesion (HSIL) – the cells are moderate to severely abnormal. These changes are likely to be precancer or cancer.
Atypical squamous cells – cannot exclude HSIL (ASC-H) – ASC-H means that changes in the cervical cells have been found that are suggestive of HSIL.
Atypical glandular cells (AGC) – suggest changes in the glandular cells that line the cervical canal.
Depending on these changes the doctor will decide regarding further management. You may require further testing in the form of colposcopy, and or biopsy.
