DEFINITION
A Pap smear is a test that checks for changes in the cells of your cervix. The cervix is the lower part of the uterus that opens into the vagina. Other terms for Pap smear are Pap test and cervical smear.

The Pap smear tests for abnormal changes in cervical cells, such as cervical dysplasia. The abnormal cells can develop into cancer if the dysplasia is not treated. The Pap smear may also detect viral infections of the cervix, such as genital warts and herpes. It may detect vaginal infections such as yeast infections or trichomonas. Sometimes the Pap smear can give information about your hormones, especially progesterone and estrogen.

Most women should get a Pap smear every one to three years. Your health care provider will recommend how often you should be tested based on your risk factors for cervical cancer.

RISK FACTORS FOR CERVICAL CANCER

• You have had an abnormal Pap smear
• You began to have sexual intercourse at an early age
• You have a history of many sexual partners
• You or your sexual partner has or has had a history of genital warts
• You have had vulvar or vaginal cancer
• Your sexual partner's previous partner had cervical cancer or abnormal cervical cells
• Your sexual partner has or had cancer of the penis
• You smoke cigarettes
• Your mother took the hormone diethylstilbestrol (DES) when she was pregnant with you
• Your immune system is weakened, for example, because you have had a transplant, you are taking immunosuppressive drugs or you have Human Immunodeficiency Virus (HIV) infection

Your health care provider may not recommend continuing Pap smears beyond age 65 if previous Pap smears were consistently normal. However, an annual exam continues to be important for other health reasons, including early detection of breast and vulvar cancer.

PREPARATION

• Do not douche or use vaginal creams during the two days before the test
• Do not have intercourse within 24 hours of the Pap smear, because it can cause inaccurate test results

PROCEDURE
A Pap smear takes only a few seconds and is performed as part of a routine pelvic examination. You lie on your back with your knees bent and your feet apart. The health care provider inserts a speculum into the vagina. The speculum is a tool that holds open the walls of the vagina. Your provider uses a special swab, brush or wooden stick to wipe off some cells from the cervix. The cells are sent to a laboratory to be viewed under a microscope.

A Pap test is not 100 percent accurate. You may want to talk to your provider about the results.

RESULTS
If the cells look normal, no treatment is necessary.

The Pap test may show that you have an infection. Your health care provider may treat you for the infection and suggest that you have another Pap test in several months.

If the cells look abnormal, more tests may be necessary. Discuss with your provider when you should return for a follow-up exam.

BENEFITS
Pap smears can detect precancerous conditions. If these conditions are discovered, there is a good chance that simple treatment will prevent the development of cancer. Pap smears are also useful for detecting some types of cervical or vaginal infections.