March 1st, 2017
Pap smear test is a cervical cancer screening tool that detects any abnormality in your cervical cells, allowing early detection of cancerous or precancerous growths. The mortality rate in United States due to cervical cancer has reduced significantly due to this smear test.
In pap smear test, the cervical cells are collected from the surface for detailed analysis. Former method involves the use of a slide on which smear is applied. Liquid cytology is the more advanced analytical method in which the sample is placed inside liquid containing vial. However, both methods are equally efficient and gives reliable results.
To determine any abnormalities, microscopic screening of cells is carried out by lab technicians. Some labs have computerized system to read the results. One thing to keep in mind is that an abnormal pap smear result does not necessarily mean that person has cervical cancer! There are numerous reasons for pap smear results not being normal:
If not having adequate sample is the reason, doctor will ask to repeat the pap smear test. For other reasons either a second pap smear test is conducted or another test called colposcopy is suggested which provides more detailed screening.
Screenings can be misinterpreted i.e. despite having cancerous or pre-cancerous growth, results are interpreted as normal. However, sometimes even if initial screening results are interpreted correctly and cervical cells appear to be normal, second time results may show presence of cancerous cells because cervical cancer expands slowly. Therefore, smart choice is to get screened time to time, at suggested intervals.
Bethesda system is the standardized way for categorizing the pap smear test results. Following are the categories in which the results can be placed:
Among abnormal pap smear results, ASCUS is the most common category. It means that abnormal cervical cells are detected but they are not cancerous. Usually it is due to HPV.
SIL indicates chances of early cancer. Based on severity they are further divided into low grade SILs (LSIL) and high grade SILs (HSIL). Usually HSILs are more likely to advance towards cancer.
The abnormal cells detected may or may not be high grades SILs.
This category indicates cancer in upper cervix, as the abnormality is detected in glandular cells and not in squamous cells.
The pap smear results clearly indicate cervical cancer.
To discuss abnormalities, doctor might use certain terminologies such as:
As mentioned earlier, pap smear test can give abnormal results due to human papilloma virus (HPV). Most of the time, HPV diminishes on its own and later the pap smear results will appear normal. But, a high-risk HPV may lead to cervical cancer! Therefore, it is essential to carry out pap smear tests at determined intervals so that doctor may decide whether the abnormalities are precancerous or not.
Doctor may also conduct HPV and pap smear test simultaneously. This will help in determining the type of HPV and will help in interpreting results more accurately. Usually women aging above 30 are suggested to take HPV test.
A pap smear test cannot screen for STDs or other reproductive cancers such as uterine, ovarian, and fallopian tube cancers.
Women aging 21 and above are recommended to take pap smear test after every 2 years. After hitting 30, if three continuous pap smear results are normal, time interval can be raised to 3 years.