What Is a Pap Smear? This Video Shows What Happens

It’s safe to say that virtually no one looks forward to getting a pap smear. Just the thought of one can lead to feelings of dread and anxiety. Even the phrase pap smear sounds unpleasant.

As awkward (and often uncomfortable) as pap smears can be, they’re vitally important. These exams check for cervical cancer, which typically doesn’t otherwise show many symptoms in its early stages. It literally could save your life, which is why OB/GYN Staci Tanouye, MD, is on a mission to change how people feel about these exams.  “[A pap smear] can seem very intimidating, but it only takes about 10 seconds, and a good doc can walk you through it gently and quickly,” Dr. Tanouye shared on Instagram recently.

To further put people’s minds at ease, she shared a video showing exactly how it’s done from the doctor’s perspective—with the help of a medical model of the female reproductive system.

To recap the step-by-step of what goes down during a pap smear: The OB/GYN inserts a speculum to help open the vagina, then they insert a metal spatula to gently scrape the outer cervix (the skin barrier that separates the vaginal canal from the uterus) to collect cells for testing. Then, the spatula is removed, and the OB/GYN inserts a small spoolie-style brush to go inside the cervix and collect cells from the inner part of the organ. Both cell samples are taken to a lab and tested to see if there are precancerous or cancerous cells.

When I reached out to Dr. Tanouye for more intel on pap smears, she told me the biggest misconception people have about them was that they screen for abnormalities in the uterus or ovaries. “Pap smears are strictly screening for precancerous and cancerous changes of the cervix,” she says. “We currently don’t have any recommended or good screening methods for either uterine or ovarian cancers.”

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Dr. Tanouye emphasizes that pap smears are important because of their role in preventing cervical cancer. “On average, cervical cancer takes around 10 to 15 years to develop,” she says. “If you get your pap smears as recommended, we will detect precancerous changes before they ever turn into cancer.”

If you’ve never had a pap smear before, Dr. Tanouye says it’s natural to wonder what the heck it will feel like. Her answer? Mild cramp-y discomfort—not exactly pleasant, but not horrendous either.

In terms of how often you should be booking an appointment to get a pap smear, Dr. Tanouye says the current guidelines recommend them once every three to five years—as long as your results don’t show any abnormalities, according to the American Cancer Society. “In the U.S., it’s recommended for everyone with a cervix age 21 and older, regardless of if they have been sexually active or not,” she adds.

To recap Dr. Tanouye’s insights, pap smears are important because they help prevent cervical cancer, don’t hurt all that much, and only take a few minutes. And health insurance is required to cover them.

Clearly getting one regularly is a big overall win. Actually it’s more than that: It’s life-saving.

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What Is A Colposcopy? – When to See a Doctor

What is a colposcopy?

A colposcopy is a type of women’s health exam. It’s often performed by your family doctor or a gynecologist. He or she uses a tool called a colposcope. It shines a light on the cervix and magnifies the view.

A colposcopy often is done if you have an abnormal Pap smear. The purpose of the exam is to get a close look the cervix. The doctor can see and diagnose problems not seen with the naked eye. For example, the doctor can detect cervical cancer at an early stage.

Path to improved health

Before the exam

A colposcopy is a short outpatient exam. It’s typically done in a doctor’s office. Prior to the exam, you should empty your bladder and bowels. Don’t douche, have sex, or use vaginal medicines or tampons 24 hours before your appointment. Let your doctor know if you’re pregnant or are allergic to latex, iodine, or medicines.

Your doctor may recommend that you take a dose of over-the-counter ibuprofen (one brand name: Advil) or other anti-inflammatory medication prior to the procedure.

During the exam

The complete exam takes about 20 to 30 minutes. The doctor has you lie face up on an exam table. You bend your legs and place your feet in stirrups, as you would for a pelvic exam or Pap smear. First, the doctor inserts a speculum into your vagina. This small tool opens your vagina so they can see inside your vagina and the outside of your cervix. Then, the doctor applies a solution of vinegar or iodine to your cervix with a cotton swab. The solution may cause a mild burning or stinging sensation. The solution makes potentially abnormal tissue turn white.

Next, the doctor looks at your cervix through the colposcope. He or she may take photographs with a tiny camera. If your doctor sees spots of abnormal tissue, he or she will perform a biopsy. This involves removing small samples of tissue from the abnormal area in or around your cervix. The samples are sent to a lab to examine.

You may experience some discomfort during the exam. You could have mild cramps caused by the speculum opening your vagina. You may feel a slight pinch and cramping if your doctor removes tissue to biopsy. Try to relax your muscles and take slow, deep breaths.

After the exam

Following the exam, you may have mild cramps. You can take an over-the-counter medicine to help relieve the pain. Ask your doctor what kind to take, as well as how much, and when to take it. You also could have some vaginal discharge for 1 or 2 days. During the biopsy, your doctor may put a thick paste on your cervix to stop any bleeding. When this paste mixes with blood, it can form a thick, dark discharge. Light spotting is normal as well. Your doctor will probably recommend wearing a sanitary pad.

You should not use a tampon, have sex, or put anything in your vagina for at least 1 week after the exam.

Things to consider

It takes about 1 to 2 weeks for the lab to process the biopsy. Your doctor’s office will contact you with the results and let you know if treatment is needed.

Normal results indicate no abnormal changes were found. Abnormal results can indicate several things.

• Cervical polyps (growths on the cervix). These aren’t cancerous.
• Cervical warts.
• HPV (human papilloma virus). The biopsy can diagnose the specific strain of the infection.
• Cervicitis (inflammation of the cervix).
• Cervical dysplasia (precancerous changes in the cervical tissue).
• Cervical cancer.

A colposcopy doesn’t have many risks. You can have mild pain, bleeding, or discharge. A colposcopy shouldn’t prevent you from getting pregnant in the future.

When to see a doctor

Call your doctor right away if you have any of the following symptoms after your exam:

• Heavy vaginal bleeding (using more than one sanitary pad per hour).
• A bad-smelling vaginal odor.
• Severe lower stomach pain.
• Fever or chills.

Questions to ask your doctor

• Is it possible to do a colposcopy if I am pregnant?
• What are the benefits and risks of a colposcopy?
• How soon after a colposcopy can I return to my normal activities?
• What types of treatment may be needed if my biopsy results come back abnormal?

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

What is a pap smear?

A Pap smear or Pap test is a screening test for cervical cancer. It is named after Georgios Papanikolaou, the doctor who determined its use in detecting early signs that could lead to cervical cancer.

It is one form of cervical cancer screening. Some women also have HPV (Human Papilloma Virus) testing.

During the exam, you lie on an exam table and a provider collects a sample of cervical cells. A speculum is inserted into the vagina to allow your provider to view the cervix. A wooden spatula and small brush are used to collect cells from the vaginal surface and canal. The process is quick and should be pain free.

The cells are put into a specimen container and sent to pathology where they are examined under a microscope to see if abnormal cells are present.

Why is a Pap smear important?

Pap smears are able to detect early mild cellular changes. It usually takes several years for abnormalities to become cancer. Our goal is to catch these changes and monitor or treat as needed to prevent progression to cervical cancer.

Who is at risk for cervical cancer?

HPV causes most cases of cervical cancer. It is a common virus that is transmitted during sexual intercourse. Most cases of HPV resolve on their own, however, some types of HPV are higher risk and can progress to cervical cancer. Smoking and coinfection with other STIs such as herpes and HIV also can increase risk.

When do I need to start getting them?

Women aged 21 to 29 years should have a Pap test alone every three years. HPV testing is not recommended. The preferred regimen for women aged 30 to 65 years is to have a Pap test and an HPV test (co-testing) every five years. It also is acceptable to have just a Pap test every three years.

University of Iowa students can schedule an appointment with a provider at Student Health and Wellness online through their MyChart account or by calling 1-319-335-8394.

Pap test Information | Mount Sinai

American College of Obstetricians and Gynecologists. Practice bulletin no. 157: cervical cancer screening and prevention. Obstet Gynecol. 2016;127(1):e1-e20. PMID: 26695583 pubmed.ncbi.nlm.nih.gov/26695583/.

American College of Obstetricians and Gynecologists website. Practice advisory: cervical cancer screening (update). August 29, 2018. www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Cervical-Cancer-Screening-Update. Published August 29, 2018. Reaffirmed November 8, 2019. Accessed March 17, 2020.

Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, Guerra CE, Oeffinger KC, Shih YT, Walter LC, Kim JJ, Andrews KS, DeSantis CE, Fedewa SA, Manassaram-Baptiste D, Saslow D, Wender RC, Smith RA. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321-346. PMID: 32729638 pubmed.ncbi.nlm.nih.gov/32729638/.

Newkirk GR. Pap smear and related techniques for cervical cancer screening. In: Fowler GC, ed. Pfenninger and Fowler’s Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 120.

Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, Huh WK, Kim JJ, Moscicki AB, Nayar R, Saraiya M, Sawaya GF, Wentzensen N, Schiffman M; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020;24(2):102-131. PMID: 32243307 pubmed.ncbi.nlm.nih.gov/32243307/.

Salcedo MP, Baker ES, Schmeler KM. Intraepithelial neoplasia of the lower genital tract (cervix, vagina, vulva): etiology, screening, diagnosis, management. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 28.

US Preventive Services Task Force website. Final recommendation statement. Cervical cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Updated August 21, 2018. Accessed June 3, 2021.

Last reviewed on: 1/1/2020

Reviewed by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Internal review and update on 06/03/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Pap Smears (for Teens) – Nemours KidsHealth

What Is a Pap Smear?

A Pap smear (or Pap test) is a medical test that helps doctors figure out if there are any problems with a girl’s cervix (the lower part of the uterus that opens into the vagina).

The importance of the Pap smear is in the early detection, before there are any symptoms. Finding abnormal cells early can lead to treatment that prevents the development of cancer, and detecting cancer cells early enough can lead to greater chance of a cure.

Who Should Get a Pap Smear?

Teen girls don’t need to get Pap smears unless their doctors think something’s wrong. Once a girl turns 21, she should start getting regular Pap smears as a way to monitor her health. Women in their 20s with normal Pap smear results should have the test every 3 years. Some women might need to get tested more often, though. So ask your doctor.

The Pap smear shouldn’t hurt, but it might be uncomfortable. The good news is, it’s over quickly.

What Happens?

A doctor or

nurse practitioneruses a small brush to wipe a sample of mucus from the cervix. The sample is sent to a lab, where technicians check it for cells that aren’t normal.

To do this, the doctor or NP will use a speculum to gently widen the vagina. A speculum is a thin piece of plastic or metal with a hinged piece on one end that allows it to open and close. If the speculum is metal, the doctor or nurse will warm it to make it more comfortable. The doctor or nurse will let you know when he or she is about to put the speculum in your vagina.

Once the speculum is in place, the doctor or nurse will gently open it up. Putting in and opening the speculum shouldn’t hurt. But some women say that it can cause a bit of pressure and discomfort.

Because the vagina is surrounded by muscles that can contract or relax, the exam can be more comfortable if you relax the muscles in that area. Try doing some breathing exercises or focusing on relaxing the vaginal muscles. Sometimes humming your favorite song or chatting with the doctor or nurse can distract you and help you feel more relaxed.

After the speculum is in place, the doctor will shine a light inside the vagina to see the cervix. The doctor will gently touch the cervix with a small brush to pick up cells from that area. Some girls say it feels like a pinch.

After the doctor or nurse has collected the sample and removed the speculum, you’ll be left alone to get dressed. Some women say that they bleed a tiny bit from the Pap smear after the exam, so they like to put a pantiliner in their underwear as they get dressed. This bleeding is no big deal — it’s nothing like a period and it won’t last.

Pap Smears

Recommendation

Don’t perform Pap smears on women under the age of 21 or women who have had a hysterectomy for non-cancer disease.

• Most observed abnormalities in adolescents regress spontaneously, therefore screening Pap smears done in this age group can lead to unnecessary anxiety, additional testing, and cost.
• Pap smears are not helpful in women after hysterectomy (for non-cancer disease) and there is little evidence for improved outcomes.

_{Sources: US Preventive Services Task Force (USPSTF) (for hysterectomy), American College of Obstetrics and Gynecology (ACOG) (for age)}

In a 2012 report, the U. S. Preventive Services Task Force (USPSTF) reviewed research published since 2003 that evaluated liquid-based cytology and human papillomavirus (HPV) testing.⁽¹⁾ The USPSTF also commissioned researchers to develop a computer model to calculate the frequency of cervical cancer screening and the ages at which to begin and end this screening. The USPSTF issued the following recommendation statements ⁽¹⁾:

• The USPSTF recommends against screening for cervical cancer in women younger than age 21 years (D recommendation).
• Available studies show that precancer or cancer of the cervix is rare in women younger than age 20. Approximately 90 percent of HPV infections in girls and young women spontaneously clear within two years.
• The USPSTF recommends against screening for cervical cancer with HPV testing, alone or in combination with cytology, in women younger than age 30 years (D recommendation).
• The USPSTF recommends screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval,  screening with a combination of cytology and HPV testing every 5 years (A recommendation).
• The USPSTF recommends against screening for cervical cancer in women older than age 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer (D recommendation).

Harms of Treatment of Screening-Detected Disease

The excerpt below is from USPTF summary statement:
 
“Screening with cervical cytology or HPV testing can lead to physical and emotional harms. Abnormal test results can lead to more frequent testing and invasive diagnostic procedures, such as colposcopy and cervical biopsy. Evidence from randomized, controlled trials and observational studies indicates that harms from these diagnostic procedures include vaginal bleeding, pain, infection, and failure to diagnose (due to inadequate sampling). Abnormal screening test results are also associated with increased anxiety and distress.

The harms of treatment also could include risks from the treatment procedure (such as cold-knife conization and loop excision) which are associated with adverse pregnancy outcomes, such as preterm delivery, that can lead to low birth weight in infants and perinatal death. Evidence is convincing that many precancerous cervical lesions will regress and that other lesions are so slow-growing that they will not become clinically important over a woman’s lifetime; identification and treatment of these lesions constitute overdiagnosis. It is difficult to estimate the precise magnitude of overdiagnosis associated with any screening or treatment strategy, but it is of concern because it confers no benefit and can lead to unnecessary surveillance, diagnostic tests, and treatments with the associated harms.”

Papanicolaou Stain – an overview

Gynecologic Cancer Screening for Transgender Men

Pap smears and human papilloma virus (HPV) testing are recommended for transgender men with a cervix, following the same guidelines for cisgender women.¹³⁷ Due to patient and provider discomfort, Pap tests are performed less frequently on transgender men than on cisgender women.¹³⁸ In addition, there is a higher rate of unsatisfactory Pap smears (10%) in transgender men, due to the physical changes resulting from testosterone, and from discomfort with exams. ¹³⁹ Insurance companies may deny coverage for Pap smears due to a mismatch between gender markers and this gender-specific testing. Clinicians should counsel all transgender men on the importance of regular cervical cancer screening, and discuss ways to assist patients with anxiety around testing. We offer relaxation techniques or light oral sedation to those patients who are fearful of vaginal inspection and speculum exams.

The USPTF recommends that clinicians defer all Pap screening until age 21. Between ages of 21 and 29, they recommend Pap smears without HPV testing every 3 years.¹²⁶ For patients aged 30 to 65 at low risk for cervical cancer, recommendations include cotesting with Pap smear and HPV testing every 3 to 5 years.^126,140 More frequent screening can be offered to people who are at higher risk due to sexual behavior.¹³⁹

For patients at low risk for cervical cancer (e.g. never sexually active) and high levels of anxiety with vaginal exam, we recommend a discussion regarding the risks/benefits of screening. Less frequent or curtailment of screening may be appropriate.¹¹⁰ Consider hysterectomy for transgender men with a high risk of cervical cancer who have persistent unsatisfactory Pap smears, or are unable to tolerate exams.

The HPV vaccination is recommended for all adolescents and young adults up to age 26.¹⁴¹ The two-dose schedule can be used when initiated between ages 9 and 14. For ages 15 to 26, the three-dose schedule is recommended.

Screening for endometrial cancer in asymptomatic transgender men is not recommended.²² Persistent vaginal bleeding despite 6 to 12 months of testosterone therapy, or return of menses after a significant period of amenorrhea without missed doses of testosterone, should initiate a workup for abnormal uterine bleeding. If no pathological etiology is identified, clinicians can treat menstrual bleeding with progesterone or aromatase inhibitors, or consider endometrial ablation or hysterectomy.²²

Some raise theoretical concerns about the risk of endometrial hyperplasia in transgender men, resulting from unopposed estrogen through aromatization of testosterone. One case report describes endometrial cancer that presented in a 51-year-old transgender man with vaginal spotting after 7 years of testosterone therapy.¹⁴² However, no increased risk for endometrial cancer has been shown, and endometrial atrophy, rather than hyperplasia, is seen in a large proportion (45%) of transgender men on testosterone.¹³² Providers should be aware that obesity, advanced age, family history of uterine cancer, and polycystic ovary syndrome increase the risk for endometrial cancer, and carry a higher index of suspicion for patients with these risk factors.¹⁴³

The USPSTF does not recommend screening for ovarian cancer in cisgender women.¹²⁶ While there have been case reports of ovarian cancer in transgender men and concerns about testosterone’s effect on ovarian architecture, a meta-analysis did not show any association between polycystic ovary syndrome and ovarian cancer.^143–145 There is no evidence to support screening transgender men for ovarian cancer.

Cytological examination of smears (scrapings) from the surface of the cervix (external uterine pharynx) and the cervical canal

Cytological examination using a special method of staining the material, which allows with high sensitivity to identify atypical cells in the smear and diagnose early precancerous changes in the epithelium and cervical cancer …

Synonyms Russian

Pap smear, Pap test, smear for oncocytology.

Synonyms English

Pap smear, Papanicolaou Smear; Cervical Smear; Cervical Oncocytology.

Research method

Cytological method.

What biomaterial can be used for research?

A smear from the outer surface of the cervix, a smear from the inner surface of the cervix (from the cervical canal).

General information about the study

Cervical cancer (CC) ranks third in prevalence among all malignant tumors in women (after breast cancer and colon cancer).The incidence of invasive cervical cancer worldwide is 15-25 per 100,000 women. Cervical neoplasms occur mainly in middle-aged women (35-55 years old), are rarely diagnosed under the age of 20, and in 20% of cases are detected over the age of 65 years.

The 5-year survival rate for localized (local, in situ) cervical cancer is 88%, while the survival rate for advanced cancer does not exceed 13%.

Risk factors for developing cervical cancer include human papillomavirus infection (oncogenic serotypes HPV16, HPV18, HPV31, HPV33, HPV45, etc.), smoking, chlamydial or herpes infection, chronic inflammatory gynecological diseases, prolonged use of contraceptives, repeated childbirth, cases of cervical cancer in the family, early onset of sexual activity, frequent change of sexual partners, insufficient intake of vitamins A and C with food, immunodeficiencies and HIV infection.

According to international recommendations, all women should be screened (pre-symptomatic examination) for cervical cancer 3 years after the onset of sexual activity, but no later than 21 years.From the age of 30, patients who have 3 consecutive negative cervical smear tests can be screened every 2-3 years. Women with risk factors (human papillomavirus infection, immunodeficiency states) should continue to be screened annually. Women 65 and older with 3 or more normal cervical smear results in the past 10 years may not be eligible for screening. Those who have had cervical cancer, have a papilloma virus infection or a weakened immune system, it is advisable to continue screening.Women who have undergone removal of the uterus and cervix may not have this test if the operation was not performed because of cancer or precancerous condition of the cervix. Those who had surgery only on the uterus, without removing the cervix, should continue to participate in the screening.

Cytological examination of material from the cervix and external uterine pharynx, stained according to the Papanicolaou method in compliance with the test method and conditions of preparation for analysis, allows with high sensitivity and reliability to identify atypical cells in the material, precancerous conditions (dysplasia, intraepithelial neoplasia of the cervix).Most often, a biomaterial obtained with a special cytobrush from two points (epithelium of the endocervix and exocervix) and fixed on a slide with 96% alcohol is examined. Material from the transformation zone should get into the smear, since about 90% of neoplastic conditions originate from the junction zone of the squamous and cylindrical epithelium and only 10% from the cylindrical epithelium. This study can also reveal signs of infection, pathology of the endocervix and endometrium.

Screening and early diagnosis of precancerous conditions and early stages of cervical cancer allow timely effective treatment and prevent dangerous consequences.

What is the research used for?

• For screening and diagnosis of precancerous diseases of the cervix.
• For screening and diagnosis of cervical cancer.

When is the study scheduled?

• For periodic examination of girls and women 3 years after the onset of sexual activity, but no later than 21 years (it is recommended to take the analysis annually and at least every 3 years).
• Every 2 to 3 years from age 30 to 65 years with three consecutive negative results.
• Annually if you have human papillomavirus (HPV), if your immune system is weakened as a result of transplantation, chemotherapy, or prolonged use of steroid hormones.

What do the results mean?

Based on Bethesda classification “ The 2001 Bethesda System terminology ”

1.Amount of material

• Complete material (adequate) – a good quality smear containing a sufficient number of appropriate cell types is considered a complete material.
• The material is insufficiently complete (insufficiently adequate) – there are no endocervical cells and / or metaplastic cells in the material, squamous epithelial cells are in sufficient quantity, or the cellular composition is poor.
• The material is defective (inadequate) – it is impossible to judge the presence or absence of pathological changes in the cervix by the material.

2. Interpretation of results:

• Negative Pap test – epithelial cells within normal limits, cytogram corresponds to age, normal.
• Benign changes – the presence of non-tumor cells, signs of inflammation (increased number of leukocytes), infection (a significant number of cocci, rods). It is possible to detect infectious agents (indicating the pathogen), for example Trichomonas, yeast.
• Changes in squamous epithelial cells (require increased attention, additional examination and if precancer or cancer is detected, treatment):

• • Atypical squamous cells undertermined significance (ASC-US)
  • Atypical squamous cells cannot exclude, HSIL ASC-H
  • Squamous intraepitelial lesion.SIL)
  • Low grade squamous intraepitelial lesion (LSIL)
  • High grade squamous intraepitelial lesion (HSIL)
  • Cervical intraepithelial neoplasia grade 1, 2 or 3, CIN 1, 2, 3)
  • Carcinoma in situ (CIS)
  • Squamous cell carcinoma – invasive carcinoma

• Changes in glandular cells (require increased attention, additional examination and if precancer or cancer is detected, treatment):

• • Atypical glandular cells (AGC)
  • Atypical glandular cells, favor neoplastic, AGC, favor neoplastic
  • Adenocarcinoma

If minimal changes or atypical cells of unclear significance are detected, it is recommended to conduct an examination for oncogenic serotypes of the human papillomavirus.

What can influence the result?

In girls under 20, false positive results are possible due to the presence of changes in the epithelium against the background of transient hormonal disorders.

Pap test, pass a smear for cytology from the cervix and cervical canal (Papanicolaou staining)

Method of determination
Microscopy

Study material
See description

Home visit available

Papanicolaou staining method is a specially developed method that allows detecting early precancerous diseases of the cervix with the highest degree of reliability.

Cervical cancer ranks third in the structure of malignant neoplasms of the reproductive system. Until 1992, the incidence of cervical cancer was decreasing, but now there is again a tendency towards an increase in this pathology. The development of the tumor occurs gradually, over several years, therefore, preventive examinations of women using a cytological method of research are very important.

Papanicolaou staining of cellular material – the Pap test – is currently used in screening programs to detect cervical cancer, precancerous and background conditions.Papanicolaou staining method allows assessing the degree of cytoplasm maturation, stains nuclei with atypia well. The term “atypia” has different interpretations in different countries: in central Europe it is defined as malignancy, in the WHO nomenclature – “less than dysplastic intraepithelial changes.”

Carrying out the RAR test has a number of features. An important point is the correct taking of the material and its fixation. The cellular material is taken with specially configured brushes in the “mirrors” to avoid the ingress of foreign material.The transfer of material should be quick, without drying; quick fixation of a wet smear in 96% ethanol is required. Papanicolaou staining of smears goes through a number of stages, then the cellular material enclosed in the balm is subjected to cytological analysis.

Test material: scrapings from the endocervix, exocervix, as well as mixed scrapings applied to a glass slide.

90,000 How to Read a Pap smear report

This article will help you read and understand the information in your Pap smear report.

Adnan Karavelich, MD FRCPC, updated December 28, 2020

Fast Facts:

• Pap test is a screening test that looks for abnormal cells in the cervix.
• The purpose of a Pap smear is to look for precancerous lesions, but it can also detect cancer.
• Most precancerous diseases and cancers in this area are caused by a virus called human papillomavirus (HPV).
• You should discuss any abnormalities with your doctor, who may recommend additional tests.

Anatomy and histology of the cervix

The uterus is a pear-shaped hollow female reproductive organ located in the small pelvis. The upper part of the uterus is called the body (body of the uterus) and the lower part is called the cervix (cervix). The body is made up of muscles that form a cavity called the endometrium. The endometrium is lined with the endometrium of the gland and stroma.

The cervix is ​​located at the top of the vagina. The narrow passage that runs through the cervix and connects the endometrium and the vagina is called the endocervical canal.The part of the cervix in the vagina is covered with special cells called flat cells. These cells form a barrier called the epithelium that protects the cervix.

The endocervical canal is covered with cells of a different type, which join to form the endocervical canal. glands. The endometrium is also lined with glands that change during the menstrual cycle. The tissue between the glands is called the stroma.

What is a Pap smear and why is it done?

Pap test (Pap smear, cervical swab) is a screening test that looks for abnormal cells in the vaginal part of the cervix.This is called a screening test because it is designed to detect an illness before a person has any symptoms. The test was named after Dr. Georgios Papanikolaou, who invented the test with Dr. Aurel Beibes in the early 20th century.

The purpose of the Pap smear is to detect precancerous diseases of the cervix. These precancerous conditions can develop into cancer over time, so it is important to identify and treat them as early as possible. A pap test can also detect abnormal cells coming from the endocervical canal or endometrium.

The most common cervical cancer is squamous cell carcinoma. This type of cancer develops from a precancerous disorder called high-grade squamous intraepithelial lesion (HSIL). The Pap test is designed to detect both squamous cell carcinoma and HSIL.

The Pap test can also detect infectious organisms, including:

• Species of Candida.
• Trichomonas vaginalis.
• Species Actinomyces.
• Herpes virus.
• Cytomegalovirus.

What causes cervical cancer?

Most cancers and precancerous diseases of the cervix are caused by a virus called the human papillomavirus (HPV). The virus infects cells on the surface of the cervix, causing them to develop into cancer cells over time. The same virus causes cancer and precancerous diseases in other parts of the body, including the throat, anal canal, vulva, and penis.

How is Pap smear performed?

The Pap test is usually performed in the doctor’s office by a family doctor, gynecologist, or qualified nurse.You will be asked to lie on your back on the examination table with your knees bent. The doctor will use a medical device called a dilator to look at the cervix. Small tissue samples will then be taken from the cervix using a soft brush and a scraping device called a spatula. For most patients, the procedure takes only a couple of minutes.

Who should get tested?

Pap smear screening for sexually active women should begin at age 21.For women who have never been sexually active, testing should be postponed until they become sexually active. Sexual activity includes intercourse as well as digital or oral sexual activity in the genital area with a partner of either gender. If no abnormal cells are found, the test should be repeated every 3 years. A woman can stop testing at the age of 70 if all her tests in the previous 10 years have been negative.

Pap test is safe and effective even if you are pregnant.Pregnant women should be screened according to the same guidelines as non-pregnant women. Women who have had their uterus removed and transgender men who still have a cervix should be screened according to the same guidelines. Immunocompromised women (HIV +, immunosuppressive therapy, autoimmune disease) should have a Pap smear annually.

In some cases, a Pap smear can be used to obtain a sample from the vagina because the walls of the vagina are lined with cells of the same type as vaginal mixtures of the cervix.The same precancerous conditions can be found in the vagina.

* These guidelines are based on the Ontario Cervical Screening Guidelines. In other provinces, the rules may differ slightly.

What are the possible results of a Pap smear?

In Canada and the United States, Pap smear results are divided into three categories:

• Normal start
• Abnormal
• inadequate

Normal start

If your Pap smear is normal, your result will be negative for intraepithelial injury or malignancy.To make this diagnosis, normal cells must be seen. Your doctor will order your next scheduled Pap test according to local regulations.

Abnormal

There are three possible types of abnormal results, depending on what the pathologist sees when examining your Pap smear under a microscope.

The three types of anomalies are divided into the following groups:

• Crayfish
• Precancerous diseases
• Preliminary Results

Each type of abnormal result is explained in more detail in the sections below.

Crayfish

This group includes both cervical and endometrial cancer. A Pap smear rarely shows another type of cancer.

The following results are types of cancer:

Cancer result requires immediate treatment. See your doctor if you get a cancer result and are not promptly informed about the next steps.

Precancerous diseases

Precancerous disease is a condition that, if left untreated, can develop into cancer over time.The Pap test is designed to detect two precancerous diseases of the cervix. Both of these diseases are caused by: human papillomavirus (HPV).

The risk of cancer is higher in patients with HSIL. If you get an HSIL result, your doctor will talk with you about your treatment options. The risk of cancer is lower in patients with LSIL, although your doctor will talk with you about having a second Pap test.

Preliminary result

A preliminary result means that abnormal cells were found in your Pap smear, but these changes were not enough to make a definitive diagnosis.The preliminary result does not mean cancer, but some preliminary results indicate the possibility of precancerous disease or cervical cancer.

You should talk to your doctor about any of the above preliminary abnormalities. In most cases, additional tests, such as a colposcopy or a repeat Pap smear, are recommended.

inadequate

In rare cases, Pap smear results may be described as inadequate.This means that your pathologist was unable to make a diagnosis based on the tissue obtained for examination. Common reasons for this include low cell counts, poor cell preservation, obstructing elements such as blood, and tissue handling errors.

A repeat Pap smear is usually performed when the result is inadequate.

Endometrial cells

Cells from the endometrial cavity (endometrium) can be seen in a tissue sample. This result is considered normal for women under 45 years of age.However, for women over 45, these cells are potentially abnormal.

If you are over 45 years of age and endometrial cells are visible on your Pap smear, your doctor may recommend additional tests. Tests may involve taking a small sample of tissue from the inside of the uterus in a procedure called an endometrial biopsy.

90,000 Pap smear. Pap test

Research method

Cytological examination of smears taken from the cervix is ​​the basis of programs aimed at the early detection of precancerous conditions and cervical cancer.The study of cytological preparations obtained from the cervical canal and the vaginal part of the cervix includes an assessment of the quality of the material obtained, determination of the presence and nature of cervical lesions in accordance with the generally accepted assessment system, including the Bethesda system.

Cervical cancer most often develops in the transformation zone, it is preceded by intraepithelial lesions (dysplasia). Due to the fact that dysplasias can be located in small, limited areas, it is very important that the material is obtained from the entire surface of the neck, especially from the transformation zone.The number of pathologically altered cells in a cytological preparation can be different, and if there are few of them, they can be missed during screening.

Various methods are used to stain smears. The Pap smear method is the most widely used smear staining technique in the world. In Russia, staining according to Romanovsky is also used in the modification of Leishman.

Indication for examination:

• screening studies for the detection of oncological pathology of the cervix;
• Monitoring the state of the cervix after therapy.

The result of a cytological study carried out in CMD can only be formalized in accordance with the terminological system of Bethesda 2014 (with Leishman stain without a description of the cytogram – studies 120015, 120016) or additionally may include a descriptive part (with Leishman and according to Papanicolaou with a description of the cytogram – studies 120001, 120002, 120003, 120004).

The Terminology Bethesda System (TBS) was developed in 1988.in Bethesda (USA, Maryland) in connection with the emergence of new knowledge about the role of HPV in the genesis of cervical cancer and with the aim of more efficient transmission of information from laboratories to clinicians, increasing the reproducibility of the results of cytological diagnostics and ensuring standardization of treatment of identified disorders. TBS is most consistent with the biology of cervical carcinogenesis and is currently implemented in most countries of the world.

Terminological system Bethesda, 2014 basic terminological characteristics and abbreviations

Pap smear (Pap test) | Central Clinic

Pap smear or (Pap test) is a minimally invasive examination method that is used to diagnose pathologies of the cervix.The pap test makes it possible to quite effectively detect precancerous changes in the epithelium – cervical intraepithelial neoplasias of varying severity.

This type of study is mandatory for women over 30 years of age, especially those who have previously or are currently found to have human papillomavirus (HPV) of high oncogenic risk, as well as for women who have zones of altered epithelium during colposcopic examination of the cervix.

The material is taken with the help of special cytobrushes, the procedure is painless and feels comparable to the usual taking of a gynecological smear on flora.

Immediately after taking the biomaterial, a smear-imprint is prepared, touching all surfaces of the cytobrush to the surface of the slide. The finished swab is placed in individual packaging (plastic or paper bag), attached to the direction with a stapler and sent to the laboratory.

According to international standards , the first Pap test is performed 3 years after the onset of sexual activity or at the age of 21 (whichever comes first).Then – once a year. If for 3 consecutive years the results of the Pap test do not reveal changes in the structure of the cells of the cervix, the Pap test is performed once every 2-3 years until the age of 65. After age 65, the Pap test can be discontinued, provided all previous results have been negative.

How to prepare for delivery?

To obtain the most accurate result, a number of conditions must be met before performing the Papanicolaou test:

1. it is not recommended to carry out the examination during menstruation;
2. it is not recommended to conduct an examination in the presence of any inflammatory process;
3. 48 hours before taking a PAP smear, refrain from sexual intercourse, the use of tampons, the use of any vaginal creams, suppositories and medications, douching and vaginal douches;
4. it is advisable to take a shower instead of a bath 2 days before the Pap test;
5. a smear should be taken before a gynecological examination, colposcopy, or not earlier than 48 hours after these manipulations.

90,000 pap test – Traduzione in russo – esempi italiano

In base al termine ricercato questi esempi potrebbero contenere parole volgari.

In base al termine ricercato questi esempi potrebbero contenere parole colloquiali.

Okay, comincio con un pap test .

Che non facciamo un pap test , signorina Figueroa.

Three years without cytological smear , Ms. Figueroa.

Dovevamo portare un kit per il pap test al dottor Papanikolau, da portarsi in Florida.

Please bring swab kit for Dr. Papanikolaou with you.

La sua proposta per dei pap test obbligatori era sulla scrivania del dottor Masters.

Your proposal for mandatory smear testing has been put on the table for Dr. Masters.

Ha un’inseminazione nella 7 e un pap test nella 8.

You have fertilization in the seventh ward and smear in the eighth in terms of fertilization today.

Andiamo a usare un po ‘di pap test , forza, ragazze!

Bene.Ora, controllando il suo Pap Test , abbiamo trovato un’anomalia.

So, we found a deviation in your smear .

Dobbiamo farle un pap test ?

È tempo di pap test , Dell.

Sarà un pap test felice.

Ok, non è un pap test felice.

Okay, not first class swab …

Il filmato sul pap test con la dottoressa DePaul questo pomeriggio, ma domani …

I’m late for lunch and then I have an appointment with Dr. DePaul.

Questo è un video educativo che vi insegnerà i semplici passi per eseguire il poco conosciuto “ pap test “.

You are watching an instructional film that teaches you simple steps on how to make a PAP smear .

Ci cresce così tanta muffa lì dentro che alla torta di ciliegie servirà il Pap test .

Per questo motivo è doveroso che un ospedale come questo faccia strada nell’educazione al Pap test .

This is why hospitals like ours are tasked with spearheading the Pap smear training.

L’università ha approvato la mia proposta del Pap Test .

Il Pap test di Colleen. DIARIO – PAP TEST

90,000 ATTENTION WOMEN!

In the antenatal clinic you can undergo an examination by liquid oncocytology free of charge

(Pap test)

Pap smear, Pap smear or cytological smear (Pap test or Pap test ) is a test that belongs to the latest methods for early detection of cervical cancer .Currently, liquid oncocytology is the most informative and reliable method for obtaining biological material, the “gold standard” for diagnosing intraepithelial neoplasias from the mucous membrane of the cervix and cervical canal.

The test is named after the Greek scientist Georgios Papanikolaou.

Pap-test allows you to effectively detect precancerous changes in the epithelium – cervical intraepithelial neoplasias of varying severity.

This type of study is mandatory for women over 30 years of age, especially those in whom the human papillomavirus of high oncogenic risk has been detected previously or are currently detected, as well as for women who have zones of altered epithelium during colposcopic examination of the cervix …

According to international standards, the first Pap test is performed 3 years after the onset of sexual activity or at the age of 21 (whichever comes first).Then – once a year. If for 3 consecutive years the results of the Pap test do not reveal changes in the structure of the cells of the cervix, the Pap test is performed once every 2-3 years until the age of 65.