What is a Pap smear?

• A Pap smear is a simple test to look at cells taken from the cervix. It tells your doctor if there are any abnormal cells on the cervix that may lead to cancer.
• A Pap smear is simple and fast. It is most often done in a doctor's office or clinic during a pelvic exam. With the woman lying on an exam table, a speculum is used to gently open the vagina. The speculum lets the doctor see the cervix and upper vagina. A small number of cells are removed from the cervix with a brush or spatula. The cell sample is then sent to a lab for testing.

Who should have a Pap smear?

• Pap smear testing is an important part of every woman's health care. A woman can have cervical cancer even if she is not sexually active or having menstrual periods.
• Most women should continue to have routine Pap smear tests after menopause.

How often should you have a Pap smear?

• Most women should have a pelvic exam yearly. It is important to note that a Pap smear is not done every time a woman has a pelvic exam. Be sure to ask if a Pap smear has been included in your pelvic exam.
• Most women will have a Pap smear done once per year. Some women will require more frequent Pap smear testing (2-4 times per year) while others can have less frequent testing. Talk with your doctor about how often you should have a Pap smear.

What do Pap smear results mean?

• Remember, the Pap smear looks for abnormal cells on the cervix. It does not detect cancer in other parts of the body, such as the uterus or ovaries. Pap smear results can fall into the following categories:
• Negative (or Normal):  There are no signs of cancer or pre-cancer.
• Atypical Squamous Cells of Undetermined Significance (ASCUS or ASC):  Some abnormal cells are seen. These cells may be caused by an infection or irritation, or they may be precancerous.
• Low-Grade Squamous Intraepithelial Lesion (or LGSIL):  Early, mild changes are seen in the cells that may show signs of pre-cancer.
• High-Grade Squamous Intraepithelial Lesion (or HGSIL):  Moderate or severe changes are seen in the cells that may be signs of pre-cancer or cancer.
• Atypical Glandular Cells of Undetermined Significance (AGUS or AGC):  Cellular changes show that further testing is needed because of an increased risk of pre-cancer or cancer of the cervix, uterus, or other reproductive organs.
• Cancer:  Abnormal cells have spread deeper into the cervix or to other tissues.
• The key to treating cervical changes is finding them early. The earlier a problem is found, the more likely it is that treatment, if needed, will work. A woman who receives an abnormal Pap test may need further testing. Such tests may include colposcopy and biopsy.
• A Pap smear result that is abnormal usually is caused by an infection called the human papillomavirus (or HPV).

What is a colposcopy?

• Colposcopy lets your doctor look at your cervix through a special device similar to a microscope. It can detect changes on the cervix that cannot be seen with the eye alone.
• For colposcopy, a speculum like the one used during a Pap smear is placed in the vagina. The colposcope remains outside the vagina, but is used to see the cervix. The cervix is swabbed with a mild vinegar solution that sometimes causes a slight burning sensation. This liquid makes abnormal cells on the cervix easier to see.

What is a biopsy?

• If an area of abnormal cells is seen, your doctor may decide that a cervical biopsy is needed. For a biopsy, the doctor removes a small sample fo tissue and sends it to a lab to be studied. You may have a pinching or cramping feeling when the biopsy is done. Colposcopy and biopsy will help your doctor determine if additional treatment is needed.

How are cervical changes treated?

• Treatment of cervical change will depend on the severity of the problem. Your doctor will discuss the appropriate traetment options available to you, such as:
• Loop Electrosurgical Excision Procedure (LEEP):  The LEEP procedure is done in your doctor's office.  Because there is some discomfort, a local anesthetic is given. For this procedure, a thin wire loop that carries an electric current is used to remove abnormal areas of the cervix. This electric energy is also used to close off the blood vessels on the surface of the cervix. This lowers the risk of bleeding after the procedure.
• Cone Biospy:  In this procedure a cone-shaped wedge of the cervix is removed. General anesthesia is typically used for a cone biopsy. The procedure is done in a hospital or surgery clinic. You should be able to go home the same day.
• Freezing or Laser Treatment:  With cryotherapy, abnormal tissue is frozen and later sheds. Sometimes laser treatment, in which a beam of light destroys abnormal tissue, is used. 

What is the human papillomavirus (HPV)?

• HPV is a very common infection that can be passed from person to person. Studies suggest that at least 3 out of every 4 people will get an HPV infection during their lifetime. Sexually transmitted HPV can spread through vaginal, anal, or oral sex. More than 30 types of HPV can infect the genital areas of a woman. Like many sexually transmitted infections, there are often no signs of genital HPV. However, a few types of HPV cause genital warts.
• Some types of HPV are linked to cancer in both men and women. Certain types are known to be a major cause of cancer of the cervix. HPV also may be linked to cancer of the anus, vulva, vagina, and penis.
• Cervical cancer develops over a long period of time. HPV causes cells on or around the cervix to become abnormal. In some cases, these cells may progress to pre-cancer or cancer. A Pap smear is the best way to detect cell changes that may be an early sign of pre-cancer of the cervix. Cancer of the cervix can be prevented with early detection and treatment.
• Currently, there is no cure for HPV, but in mose cases it will be cleared in a few months by your body's immune system.
• There is a vaccine available to help protect against the most problematic strains of HPV. Talk to your doctor to find out if you are a good candidate for the vaccine.
• To lower your chances of HPV infection you should not smoke, limit the number of sexual partners, and use condoms when you have vaginal, anal, or oral sex. Condoms cannot fully protect you against HPV infection, since it can be passed by touching infected areas not covered by the condom.