OB/GYN — Papanicolaou Smear (Pap Smear)

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A Papanicolaou smear (Pap smear) is a microscopic examination of cells taken from the cervix, that is used to detect cancerous or precancerous condition.

How should you prepare for a Pap test?

Many things can cause inaccurate test results by washing away or hiding abnormal cells. For two days before the test you avoid:

• Douching
• Using tampons
• Using vaginal creams, suppositories, and medicines
• Using vaginal deodorant sprays or powders
• Having intercourse

Depending on the result, specific follow-up will be recommended by your health care provider. This can be anything from simple treatment of a mild infection to a detailed examination using a colposcopy.

Think of cervical cancer as a slow progression from totally normal to abnormal and eventually malignant and cancerous. Our goal is finding an abnormality on the "normal end" of the time line, so we can prevent it from progressing further.

"The Time Line"

NORMAL ~> BENIGN CHANGES ~> ASCUS ~> LGSIL ~> HGSIL ~> CERVICAL CANCER

• Benign Changes: include inflammation, mild infection, age-related atrophy, IUDs.
• ASCUS: (Atypical Squamous Cells of Undetermined Significance). This is a broad category indicating a mild abnormality.
• LSIL: (low-grade squamous intraepithelial lesion) early changes in the cells often associated with the presence of HPV(human papillomavirus).
• HSIL: (high-grade squamous intraepithelial lesion) cells are very different from normal cells. These cells are usually precancerous and are more likely to lead to cervical cancer.

What is a colposcopy?

A colposcopy is a procedure that allows your provider to closely examine abnormal cells on your cervix. Your provider will coat your cervix with a solution that causes any abnormal areas to turn white. Then they will examine these areas using a colposcope, an instrument like a microscope. A small piece of tissue may be removed for study in a laboratory. This is called a biopsy.

Normally this is done by your PCM, but can be performed by the WHC, by having your PCM place a consult request (referral) to the WHC.