Abnormal Pap Test | Michigan Medicine

Topic Overview

What is an abnormal Pap test?

When your doctor says that your Pap test, or Pap smear, was abnormal, it means that the test found some cells on your cervix that do not look normal.

A Pap test may be done as part of a woman’s routine physical exam, because it’s the best way to prevent cervical cancer. But having an abnormal test result doesn’t mean you have cancer. In fact, the chances that you have cancer are very small.

What causes an abnormal Pap test?

Most of the time, the abnormal cell changes are caused by certain types of human papillomavirus, or HPV. HPV is a sexually transmitted infection.

Usually these cell changes go away on their own. But certain types of HPV have been linked to cervical cancer. That’s why regular Pap tests are so important.

Sometimes the changed cells are due to other types of infection, such as those caused by bacteria or yeast. These infections can be treated.

In women who have been through menopause, a Pap test may find cell changes that are just the result of getting older.

What increases your risk for an abnormal Pap test?

Certain sexual behaviors, like having sex without condoms and having more than one sex partner (or having a sex partner who has other partners), can increase your risk for getting HPV. And HPV raises your risk for having an abnormal pap test.

HPV can stay in your body for many years without your knowing it. So even if you now have just one partner and practice safer sex, you could still have an abnormal Pap test if you were exposed to HPV in the past.

Smoking or having an impaired immune system also raises your chances of having cell changes in your cervix.

Do abnormal cell changes cause symptoms?

The cell changes themselves don’t cause symptoms. HPV, which causes most abnormal Pap tests, usually doesn’t cause symptoms either.

If a different sexually transmitted infection is the cause of your abnormal test, you may have symptoms such as:

• A discharge from the vagina that isn’t normal for you, such as a change in the amount, color, odor, or texture.
• Pain, burning, or itching in your pelvic or genital area when you urinate or have sex.
• Sores, lumps, blisters, rashes, or warts on or around your genitals.

What will you need to do if you have an abnormal Pap test?

You may need more tests to find out if you have an infection or to find out how severe the cell changes are. For example, you may need:

• Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool.
• An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.
• Another Pap test in about 6 to 12 months.

A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also takes a small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a biopsy.

Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.

Cause

Most abnormal Pap tests are caused by HPV infections.

Other types of infection—such as those caused by bacteria, yeast, or protozoa (Trichomonas)—sometimes lead to minor changes on a Pap test called atypical squamous cells.

Natural cell changes that may happen during and after menopause can also cause an abnormal Pap test.

What increases your risk of having an abnormal test result?

Certain sexual behaviors—such as having sex without condoms and having more than one sex partner—increase your risk of getting an HPV infection. And an HPV infection raises your risk for having abnormal test results.

Other things that may also play a role in increasing your risk include:

• Smoking.
• Having an impaired immune system.
• Having been exposed to the drug DES while your mother was pregnant with you, though this is rare.

If you have had one abnormal Pap test result, you’re more likely to have another in the future.

Types of Results

Lab specialists label abnormal cells according to how abnormal they are—how different they are from normal cells. Knowing what type of abnormal cells you have helps your doctor decide on treatment.

Minor cell changes

Minor cell changes may disappear without treatment. But sometimes they turn into more serious cell changes. Types of minor cell changes are:

• ASC-US or ASC-H. These are changes for which the cause is unknown. ASC-US changes usually stay the same or return to normal. ASC-H changes are also minor but have a higher likelihood of becoming more serious.
• LSIL. These changes may be more likely to become more severe over time, but even when they do, they usually return to normal.

Moderate to severe cell changes

Moderate to severe cell changes
—HSIL and AGC—are more likely to be precancerous and turn into cervical cancer if left untreated.

In some countries, other labeling systems are used. These systems may use the term dysplasia to describe cervical cell changes. Or they may simply describe the changes as mild, moderate, or severe.

Follow-Up Tests

When your Pap test result is abnormal, you always need to follow up with your doctor. Often this just means having regular checkups and Pap tests. But sometimes it means more tests or treatment.

It’s very important to complete any further testing that your doctor recommends.

Watchful waiting

Most women won’t need special testing or treatment. Instead, they’ll follow a schedule of regular Pap tests to watch for cell changes. This is called watchful waiting. It may be recommended when:

• You have a treatable infection in the vagina or cervix.
• You have an HPV infection. Most low-risk types of HPV go away on their own within 6 to 18 months.
• Your cell changes are minor.

It’s okay to do nothing but watch and wait, because minor cell changes such as ASC-US or LSIL don’t usually become more severe during a short period of watchful waiting.

Watchful waiting may not be a good choice if you don’t think you’ll be able to follow your doctor’s recommendations about having regular Pap tests. Talk with your doctor about your testing choices.

More testing

After an abnormal Pap test, you may need more tests to look for infection or to find out more about your cell changes. These tests include:

• HPV test

  . This test looks for high-risk types of HPV (human papillomavirus). Knowing whether you have a high-risk type of HPV can help guide your treatment decisions.

• Colposcopy

  . In this test, your doctor uses a magnifying instrument to look at your vagina and cervix. The doctor takes a small sample of tissue so that it can be examined under a microscope.

• Cone biopsy

  . A cone biopsy removes a little more tissue than a cervical biopsy. It may also serve as treatment by removing the abnormal cells.

• Tests for other infections, such as other sexually transmitted infections, a yeast infection, or a bacterial infection.

Tests and Treatments

The type of treatment you have will depend on what caused the abnormal test results.

Infection: If your abnormal test results were caused by a vaginal infection or a sexually transmitted infection, you can be treated with medicine.

Menopause: Women near menopause may have abnormal results because of normal body changes during menopause. These minor cell changes may improve with the use of estrogen cream.

Moderate or severe cell changes, such as HSIL. Your treatment will focus on destroying or removing the abnormal tissue. Treatment choices include:

For cervical cancer, treatment will focus on destroying or removing the cancer. To learn more, see the topic Cervical Cancer.

A pregnant woman with an abnormal Pap test is monitored closely throughout her pregnancy. Monitoring may include a colposcopy. The goal is to rule out cervical cancer, a rare diagnosis. If cancer is ruled out, treatment for abnormal cell changes is done after delivery.

Credits

Current as of:
December 17, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
Kevin C. Kiley MD – Obstetrics and Gynecology

Current as of: December 17, 2020

Author:
Healthwise Staff

Medical Review:Sarah Marshall MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kathleen Romito MD – Family Medicine & Kevin C. Kiley MD – Obstetrics and Gynecology

What You Need To Know About Abnormal Pap Smears

If your pap smear test comes back as abnormal, or positive, it means there is an unusual cell appearing in your cervix. This result does not mean you have cervical cancer. Most often, these test results are the sign there have been cell changes caused by HPV (human papillomavirus). HPV is the most common STI (sexually transmitted infection) and in some cases, is linked to cervical cancer. The changes showing in your cervical cells can be moderate to severe.

What is a Pap Smear?

Pap smear or pap test is part of a pelvic exam. Pap is short for Papanicolaou, which comes from the doctor’s name, who studied changes in cervical cells. A pap smear is generally performed on a woman when she reaches the age of 21 unless there are unique health risks involved, such as HIV. The pap smear is the only method available to check the cells on your cervix to locate changes that can lead to cancer. If you are at risk for sexually transmitted infections (STI), your doctor at All Women’s Care would also check for gonorrhea or chlamydia at the same time a pap smear is done.

How is a Pap Smear Performed?

Your physician at All Women’s Care will insert a speculum into your vagina, so they are able to examine your cervix. Using a small plastic wand with a brush attached, they will then gently scrape a sample of cells from your cervix for testing. The pap smear should not be done during your menstrual cycle, as this can affect the results of the test. You should also not douche or use any other products to clean your vagina before having the smear.

Most women experience a small amount of cramping when their cervix is brushed, but this sensation should last only a minute or less. The cell samples will be placed in a glass bottle or on a glass slide and sent to the lab. A trained technician will examine the cells under a microscope to check if there are any abnormalities and report the findings to your doctor.

Results of a Pap Smear

Most times, the results of a pap smear return as normal; however, it is not uncommon for the results to come back as abnormal. The specialists in the lab will label abnormal cells according to how different they are from normal cells. Knowing the type of abnormality will help your doctor at All Women’s Care decide on your treatment. Minor cell changes can disappear without the need for treatment, moderate to severe cell changes are more likely to be an indication of precancerous and could turn into cervical cancer.

These are some of the terms used to define the results of a pap smear:

• Benign changes

  This test result indicates your pap smear was basically normal, but there is an infection present that has caused inflammation of your cervical cells. You may need another pelvic exam to find the cause of the infection and receive treatment.

• Abnormal or ASCUS

  ASCUS stands for atypical squamous cells of undetermined significance’ and means your test results are abnormal. An abnormal result indicates there are some cells in your cervix that are not ‘normal’ and need to be checked for possible HPV.

  ASCUS happens when your cells are not typical. Your doctor at All Women’s Care will perform a test with a special liquid to check for HPV. If none is detected, there is no reason for concern.

These are some guidelines used in young women under the age of 24:

• Low-Grade Squamous Intraepithelial Lesion (LSIL)

  A test result of LSIL present indicates you have been infected with HPV (human papillomavirus), and will need to have a pap smear repeated within the next twelve months. This result could also require you to have a colposcopy.

  If the repeat smear after twelve months is again abnormal, another follow up is requested in twelve more months. The doctor may ask that you have a colposcopy and, depending on the results return to pap smear schedule of every three years, or return in twelve months.

  • Colposcopy

    A colposcopy is a procedure to examine your vagina, cervix, and vulva closely for any signs of disease. The doctor uses a special instrument called a colposcope, which will provide them a magnified view of these areas. It is a nearly pain-free procedure, with some reporting only a small amount of pressure as the instrument is inserted.

• ASC-H

  Results showing ASC-H indicates your cervical cells are not typical and may be related to HPV. This result considered the cells to be ‘atypical,’ and ‘H’ means there is the possibility of ‘high-grade’ changes in your cervix. If you get an ASC-H result on your pap smear, the doctor will require you to have a colposcopy.

• High-Grade Intraepithelial Lesion (HSIL)

  Test results indicating HSIL means the cells in your cervix are showing a change. The changes are more severe than a low-grade change. You most likely do not have cancer at this point, but if you do not receive treatment, you are at risk for developing cervical cancer. Having a colposcopy and treatment can prevent cancer from developing.

• Cancer

  It is rare in women under the age of 24, but if the results come back from the pap smear showing cancer cells, you will have to be seen by a gynecologist who specializes in cancer. Treatment should be sought immediately and may require surgery. The earlier you catch and treat this form of cancer, the higher your success rate will be of remaining healthy.

What it Means to Have an Abnormal Pap Smear

Millions of women have a pap smear each year as a means of screening for cervical cancer. It is a simple procedure and part of a woman’s routine visit to a gynecologist. Your doctor swabs some cells from your cervix and sends them to the lab to determine if they are normal or abnormal.

A majority of pap smears come back normal, and you can sigh with relief, and schedule your next exam a few years down the road. There is only two to five percent of the women who have a pap smear that has results come back abnormal. If you happen to fall into that group, you may be a bit nervous. This information will help you understand what it means to get an ‘abnormal’ test result on your pap smear.

Causes of an Abnormal Pap Smear

Abnormal cells on your pap smear results are not an indication of cancer.  There are numerous reasons your results came back as abnormal. The most common is HPV (human papillomavirus).

While HPV is the leading cause of abnormal pap smears, it does not mean you have cervical cancer. According to a study at the Henry Ford Health System in Detroit, almost ninety percent of the time this is the cause for the abnormal pap smear, it clears on its own without causing cancer. A lot of the time, women who have this condition have no symptoms or experience only mild symptoms.

When HPV does lead to precancerous or cancerous changes in your cervical cells, those cells will be categorized as mild, moderate, or severe. From this point, your doctor at All Women’s Care will discuss your options.

Other causes can explain why you have had an abnormal pap smear. There are other sexually transmitted infections (STI) that can be blamed, as well as gonorrhea and chlamydia. Yeast infections and bacterial vaginosis will also cause changes in your cervical cells. All of these conditions are treatable.

• Yeast Infection

  Yeast is a fungus and lives typically in a vagina in small numbers. When you develop a yeast infection, it indicates too many yeast cells are growing. Yeast infection is common among women, and they can become quite bothersome, but are not serious.

  These infections develop when something happens to change the balance of the yeast. Antibiotics are sometimes the cause of the imbalance, as well as high estrogen levels caused by hormone therapy or pregnancy. Health issues such as HIV or diabetes are other causes of a yeast infection.

  When you develop a yeast infection, you can experience soreness or itching in the vagina, and in some cases, it causes burning or pain during urination and sex. You may also notice a thick, clumpy discharge that looks somewhat like cottage cheese. It is easy to misdiagnosis this condition yourself. You should see your doctor at All Women’s Care if you suspect you have a yeast infection.

• Bacterial Vaginosis

  Bacterial vaginosis is a mild form of infection in the vagina. There is normally a lot of good bacteria and bad bacteria in a woman’s vagina. The good will control the growth of the bad. When you develop bacterial vaginosis, the balance has become upset. This condition is treatable, but when present, it can cause an abnormal pap smear result. If the condition is untreated, it can lead to more serious problems. You should see your doctor at All Women’s Care to seek treatment if you think you have this infection.

  Symptoms of bacterial vaginosis include a smelly discharge, which may look yellow or white. You could also experience a ‘fishy’ smell after sexual intercourse. Most women do not notice symptoms with this infection.

As a woman ages and enters menopause, it can produce changes in the cervical cells as well. When the body stops producing as much estrogen, the cells will begin to look funny and can even mimic precancerous conditions.

What To Do If Pap Smear is Abnormal

Having a pap smear is to find out if something is going on in your cervix, but it doesn’t tell you what is happening if the test is abnormal. Your doctor at All Women’s Care will want to schedule a follow up to find out what the results mean. The majority of women do not need special testing or treatment; the follow-up pap smear is common practice.

It is acceptable to wait and perform a second pap smear, as minor cell changes usually do not become more severe during a short period of time. Watchful waiting is common when a pap smear comes back abnormal, especially if it is your first one.

Your doctor may request a second pap smear as a way of ruling out errors in the test and see if there are signs of HPV DNA. This second test will tell the doctor if you have HPV and that it is the reason your pap smear test came back abnormal. This second test can even alert the doctor if you have one of the specific strains of HPV (16 or 18), which causes cervical cancer.

The next step may be to order a colposcopy; however, not every abnormal pap smear means a colposcopy is needed. In younger women, especially, this test is seldom used as their risk of cervical cancer is very low. In cases of younger women (under the age of 25), a second pap smear is generally requested with six months of the abnormal one to determine if the results will still be abnormal.

Every year there are approximately 13,000 women who receive a diagnosis of cervical cancer, and around 4,000 of them die from this cancer. Most of these cases are preventable if patients schedule and have a pap test or do the appropriate follow-ups.

What to Expect if You Need a Colposcopy after Abnormal Pap Smear

If your pap smear results come back as ‘abnormal’ as listed above, there are certain times this result may require you to have a colposcopy. When you have a colposcopy, you will be asked to undress from the waist down. Typically, there is a consent form for you to sign before your physician begins.

You will lie down on the exam table with your feet placed in the holders or stirrups. A colposcopy specialist will then gently insert a speculum into your vagina the same way as when you had your pap smear. The speculum separates the vaginal walls so your cervix can be examined. With the use of a colposcope to magnify your cervix, the doctor will perform an exam of your cervix walls.

The colposcope only touches the outside of your vagina and not you. This tool is similar to a large magnifying glass, and with it, your doctor can look at the tiny cells on your cervix. The doctor will swab your vagina and cervix with a vinegar solution. This solution will temporarily cause unhealthy cells to change their color so the doctor can observe them easier. If unhealthy cells appear, the specialist will more than likely take a sample of them to perform a biopsy.

A sample of the unhealthy cells is taken with a tool similar to tweezers. The sample will be placed in a jar that has a preservative liquid inside. The jar is then sent to the lab, where they will check the sample for any signs of disease.

The procedure of colposcopy is not usually uncomfortable. It is described as a long pelvic exam to allow your doctor to examine your cervix. The biopsy, if necessary, can cause some discomfort, but this sensation would last less than a minute. Some women report they feel a slight pinching or experience mild cramps, while others report feeling nothing after a biopsy. If you are concerned about experiencing discomfort during your colposcopy, you can take an over-the-counter pain reliever before your procedure. Pain relievers, such as naproxen sodium or ibuprofen, should help with any pain. If you experience any discomfort during a pap smear, then you would benefit from taking these pain relievers before a colposcopy.

Once the procedure is over, the specialist will explain what they saw and if they have taken a sample for further examination. If they did remove a sample, the test results for this should be returned to your doctor within two to three weeks. What you might experience after a colposcopy:

• It is not uncommon for some slight bleeding to occur after a biopsy or perhaps some spotting
• If you notice any sign of blood after your procedure, you should use pads and not a tampon
• There may be some clumps or brownish material appearing in your panties or underwear after a biopsy. This discharge is common and not a reason for concern. The clumps will last up to five days and are from a solution used during your procedure to control bleeding
• There may even be a black-looking discharge after your biopsy. If your doctor used a solution known as ‘silver nitrate’ to control bleeding, it would result in a black-looking discharge. This discharge is also common and not a cause for alarm.
• For 48 hours after your procedure, you should not use tampons, douche, or have sexual intercourse.

Risks for Causing Abnormal Pap Smears?

Certain sexual behaviors put a woman at risk for an abnormal pap smear. One practice is having unprotected sex. Not using a condom puts a woman at risk for numerous health risks, and having an abnormal pap smear is one. Another risk is having more than one sex partner as this increases your risk for HPV, and HPV raises the risk of abnormal pap tests.

HPV can stay in a person’s body for many years without them even knowing it. So, even after a woman commits herself to one partner, she could still have an abnormal pap smear, as she could have contracted HPV in the past.

Other risks of receiving an abnormal test result include smoking or having an impaired immune system. These can both change the cells in the cervix. If you were exposed to the drug, DES, while your mother was carrying, you could also cause abnormal pap smear results, although this is rare.

• Impaired Immune System

  The immune system is your body’s natural defense system, which fights infections. If your system is impaired, it is not working correctly and will not protect you from infections. There are some medications and health conditions which can impair or weaken your immune system:

  • Radiation or chemotherapy treatments
  • Drugs such as corticosteroids taken to suppress the immune system after an organ transplant
  • Substance use disorders
  • Certain diseases such as cancer, diabetes, AIDS/HIV

• DES

  Between the years of 1948 and 1971, women were given a drug called diethylstilbestrol (DES) as a means to prevent a miscarriage. Daughters who have been born to an expecting mom who took this drug have an increased risk of developing:

  • Abnormal cervical cells which will lead to abnormal pap smears
  • Vaginal cancer
  • Problems with the structure of their reproductive organs such their uterus being T-shaped which causes infertility

Are There Symptoms With Abnormal Cell Changes?

When cells change in the cervix, the change itself does not cause symptoms. If HPV has caused the change, there typically are not any symptoms related to this condition. If the cause for your abnormal pap smear results from a sexually transmitted infection, you could have symptoms related to the infection, which include:

• A discharge which is not typical as it has a different texture, odor, or color
• A painful itching or burning in your genital or pelvic area during urination or sex
• The appearance of rashes, blisters, lumps or warts around the genitals

Where Can I Learn More About Abnormal Pap Smears Near Me?

Call or visit one of our physicians at All Women’s Care 213-250-9461 if you have received an abnormal pap smear on your last exam. We have been treating women in the local community with the highest standards and can provide you answers to all your questions regarding abnormal pap smear results. Using the most up to date procedures and protocols, we cover a wide range of women’s health issues and are ready to help you.

How a Pap Test Can Save Your Life: OB/GYN Specialists: OB/GYNs

Because January is National Cervical Cancer Awareness Month, our team at OB/GYN Specialists reminds you about the importance of a routine Pap test. This simple, noninvasive screening is your first line of defense against cervical cancer and other reproductive health issues.

Basics of a Pap test

A Pap test is a preventive screening used to identify the earliest stages of cervical cancer. The test can also determine if there are abnormal cells developing in your cervix, which can increase your risk for cancer in the future.

Generally, a Pap test is recommended for women beginning at the age of 21 and should be repeated every one to three years. If you have a history or a family history of cancer, you may need testing more often.

Pap tests are done during a routine pelvic exam. Your doctor collects a sample of your cervical cells. This collection process is easy, requiring only a quick swabbing of your cervical area. Once the cells are collected, your doctor sends them to a medical laboratory for further analysis.

The outcome of a Pap test

The results of a Pap test are classified as either normal or abnormal. Normal test results indicate there are no changes in cervical cells and no sign of cancer.

If your results are abnormal, it doesn’t automatically indicate you have cancer. There are a number of reasons your Pap results can be abnormal, and your doctor may recommend another Pap test before recommending the next step.

Possible reasons for abnormal Pap test results besides cancer include:

• Vaginal infection
• Recent sexual activity
• Urinary tract infection (UTI)
• Recent use of tampons or douche

Abnormal Pap test results may also detect the presence of human papillomavirus (HPV), a sexually transmitted disease that can cause genital warts and increase your risk for cancer.

In some cases, your Pap test results may come back abnormal for no reason at all.

Early cancer detection

If your abnormal Pap test results do indicate the presence of precancerous or cancerous cells, your doctor may administer another Pap test to confirm the results. They may also perform an HPV test to confirm or rule out the presence of an infection.

If there’s a concern for cancer, you likely will undergo a colposcopy procedure, where a special microscope is inserted into your vaginal canal to closely evaluate your cervix.  During this test, your doctor may perform a biopsy.

This type of biopsy is known as a cone biopsy, where a small, cone-shaped portion of cervical tissue is removed for evaluation. The specific shape of tissue ensures your doctor removes a good sample of cells in an area where abnormal cells typically form.

If cancerous cells are present, they can be effectively destroyed through a freezing process or through a loop electrosurgical excision procedure (LEEP). This procedure uses a specialized heated wire instrument that removes affected cervical tissue.

In many cases, a LEEP procedure can remove all abnormal cells. If your biopsy confirms cancer, your OB/GYN Specialists doctor works closely with you to determine the best course of treatment.

Why early detection matters so much

Because the efficiency of a Pap test can help your doctor identify and remove abnormal cells quickly, it goes without saying that this simple preventive screening can save your life. Otherwise, abnormal and cancerous cells can take months or years to show symptoms — often when it’s too late for treatment to be effective. For this reason, routine Pap tests are a must for all women.

Schedule your Pap test today and learn more about the right testing schedule for you by calling OB/GYN Specialists or using the online booking feature.

Pap Smear vs STD Testing: What You Need to Know – Lona Sasser

Want to learn about Pap smear vs STD testing? You’re not alone; many women are searching the web for this topic. Most women between the ages of 21 and 65 receive a Pap smear every 3 years. But, while you know you’re supposed to get this important test regularly, do you know the reasons for getting it? Keep reading to learn the differences and similarities between a Pap smear vs STD testing.

If you are seeking a wonderful new gynecologist to perform this important test, to discuss all manner of women’s health-related questions and concerns, for obstetrical care, or for many other services, welcome to our practice! At Lona Sasser Obstetrics and Gynecology in Coral Springs, Florida, we have three excellent doctors on staff: Dr. Lona Sasser, Dr. Jose Berthe, and Dr. Mary-Beatrice Squire. All of them are rated an average of 5/5 stars by patients on ZocDoc, and have become trusted figures in our community for their expert and compassionate care.

Book an Appointment Today!

Pap Smear vs STD Testing: Are They Different?

A Pap smear is a screening test that takes a sample of cells around the cervix — which is located at the top of the vaginal canal, and is the entrance to the uterus. A Pap smear is performed to detect abnormal cervical cells. Certain types of abnormal cells can lead to cervical cancer, which is frequently caused by an infection with the Human Papilloma Virus (HPV). A Pap smear is different from an HPV test, but by detecting abnormal cells, it can indicate the presence of HPV.

According to ZocDoc,

During the Pap smear, your doctor may choose to collect samples of the fluid around the cervix to test for Gonorrhea or Chlamydia. Other tests that your doctor may choose to perform as part of a standard STD screen include urine testing for Gonorrhea or Chlamydia, and blood testing for HIV, Hepatitis B, and syphilis.

A Pap smear only tests for signs of HPV, and not for other STDs or their effects. There are many reasons to get tested for STDs, but an STD test is not automatically included as part of a well woman exam; you may need to request it at your appointment. If you have had unprotected sex with a new partner, if you or your partner have not been tested for STDs recently, or if you notice any of the symptoms listed in this article, it is a good idea to discuss STD testing with your doctor!

Pap Smear vs STD Testing: When to Get Tested?

It is recommended that women between the ages of 21 and 65 get a Pap smear every 3 years. Your annual well woman exam is an excellent time to get this screening test performed by your gynecologist. While you’re at it, consider requesting additional STD testing, which can easily be done during or after your Pap smear.

Discuss questions about Pap smear vs STD testing with a gynecologist. Book online today!

Pap Smears, STD Testing and More

At our practice, we provide Pap smears, STD testing, and many more services to our valued patients. Explore our services here!

Sources for This Article:

Which STDs Can Be Detected By a Pap Smear? – ZocDoc

Bacterial vaginosis: comparison of Pap smear and microbiological test results

Bacterial vaginosis is a commonly encountered cause of vaginitis. The most common form of vaginitis in the US is bacterial vaginosis.⁸ The average incidence of bacterial vaginosis varies; the rates are 10–35% in patients visiting gynecological wards, 10–30% in patients visiting obstetric wards and 20–60% in patients visiting services of sexually transmitted disease.⁹ Among the women we investigated, 29.4% of them had bacterial vaginosis. This prevalance is higher than our previous study result, which was 9.1%.¹⁰ Bacterial vaginosis is associated with many obstetric and gynecologic complications, including preterm labor, preterm premature rupture of membranes, chorioamnionitis, puerperal endometritis, pelvic inflammatory disease, urinary tract infection, postoperative cellulitis, and cervical dysplasia.^{11, 12}

The chief complaint of patients with bacterial vaginosis is malodorous vaginal discharge. Approximately 50% of patients with bacterial vaginosis do not have any symptoms.⁹ The diagnosis of bacterial vaginosis is usually established according to the clinical criteria or microbiological tests. Bacterial vaginosis is often misdiagnosed using clinical criteria because the components are subjective and dependent on the performance of the clinician and available equipment.^{4, 13} The use of vaginal cultures for G. vaginalis is limited by the test’s poor specificity.¹⁴G. vaginalis commonly occurs in the vagina of women without bacterial vaginosis and bacterial vaginosis may be produced by microorganisms other than G. vaginalis.¹⁵ The results of the study by Nugent et al⁴ indicated that the criteria for diagnosis of bacterial vaginosis using Gram stain can be produced reliably by different centres and microbiologists. It is also reliable when evaluating an asymptomatic population.¹³

Platz-Christensen et al¹⁵ reported that detection of clue cells in Pap smears showed a sensitivity of 90% and a specificity of 97% when compared with clinical diagnosis of bacterial vaginosis. They did not specify whether they obtained their specimens from the cervix or the vagina.

Schnadig et al¹⁶ reported a high correlation between Pap smears and Gram smears for the diagnosis of bacterial vaginosis. Pap smears were more accurate than wet preparations for identifying clue cells. They suggested that lactobacilli pseudoclue cells were probably one cause for false–positive identifications of clue cells in wet preparations.

Davis et al¹⁴ reported that compared to the Gram stain, cervical cytologic test results had a sensitivity of 55%, specificity of 98%, a positive predictive value of 96%, and a negative predictive value of 78%.

Hillier¹⁷ stated that in their experience, diagnosis of bacterial vaginosis by examination of Pap smears is less specific than the Gram stain of vaginal fluid because standardized criteria for the evaluation of Pap smears have not been routinely applied. They believe that bacterial vaginosis is diagnosed best on the basis of vaginal and not cervical specimens.

We determined that Pap smear has a sensitivity of 43.1%, and a specificity of 93.6% for the diagnosis of bacterial vaginosis when compared to Gram stain. We compared the cervical smear with Gram stain, because clinical criteria are subjective and have interpractitioner variability. We used the diagnostic criteria of the Bethesda system to diagnose bacterial vaginosis on cervical smear, because, clue cells alone are not sufficient to diagnose bacterial vaginosis. As it is a routine cytologic procedure, we evaluated the cervical, not vaginal smear for the diagnosis of bacterial vaginosis. This can also explain the low sensitivity we determined.

We determined that vaginal culture has a sensitivity of 77.8%, and a specificity of 97.7% for the diagnosis of bacterial vaginosis when compared to Gram stain.Vaginal cultures for G. vaginalis are often the primary laboratory test available for the diagnosis of vaginitis. Although it has a sensitivity of 83–94% among the women who have clinical signs of bacterial vaginosis,^{18, 19, 20} the usefulness of these cultures is doubtful.¹⁷G. vaginalis commonly occurs in the vaginas of women without bacterial vaginosis and bacterial vaginosis may be produced by microorganisms other than G. vaginalis. According to our results, with a specificity of 97.7%, and a positive predictive value of 93.3%, it seems likely that, vaginal culture is an adequate diagnostic criteria when it is positive.

One of the most important complications of bacterial vaginosis is cervical dysplasia. It is hypothesized that bacterial vaginosis could be important in the development of neoplasia of the cervix, because the abnormal microflora in this condition produce carcinogenic nitrosamins.²¹ In this study, only one of the patients had high-grade cervical intraepithelial neoplasia and both of her test results were positive for bacterial vaginosis. The hypothesis above should be tested among the women in whom cervical neoplasia is more prevalant.

Although cervical smear is a routine procedure for screening cervical cancer, it is less sensitive than microbiological test results for screening of bacterial vaginosis, particularly when compared with Gram stain evaluation. However, because of its high specificity, it may be an adequate diagnostic criteria when it is positive.

Pap Smear | Women’s Health

Overview

A Pap smear is a microscopic cervical screening test that women’s health specialists use to test for potentially precancerous and cancerous cervical cancer. Early diagnosis often leads to an increased chance of successful treatment.

A Pap test can also detect certain viral infections such as human papillomavirus (HPV). 

Pap smears can sometimes be referred to as Pap tests. 

Candidates for a Pap Smear

All women should begin having regular Pap smears around age 21 (or when sexually active), and can usually stop having them around age 65. Depending on your age, your doctor will recommend testing frequency.

If you’ve had a total hysterectomy, talk to your doctor about your options.

Certain risk factors may play a part in the frequency of getting a Pap smear done. These risk factors include:

• Having cervical cancer
• A previous Pap smear revealing precancerous cells
• Having an HIV infection
• Being a smoker

Preparing for a Pap smear 

Once you’ve scheduled a Pap smear, avoid the following actions for two days prior to the procedure, as they may have an effect on the results of your Pap smear:

• Intercourse
• Douching
• Using vaginal creams or jellies

If possible, you should try and schedule your Pap smear when you are not on your menstrual cycle.

Expectations of a Pap smear

You will need to undress and wear a gown that the office provides. You will lie on your back on an exam table, with your knees bent and your feet in supports. Your doctor inserts a speculum (specialized instrument) into your vagina. The speculum holds your vagina open so the doctor can examine your vagina and see your cervix. Your doctor then uses a flat scraping device (spatula) to collect some cervical cells. It may be a little uncomfortable, but this should not hurt — you may feel some slight discomfort due to the speculum. 

Recovery from a Pap smear

After the Pap smear, you can return to your normal activities immediately. Your doctor will send the cervical cells collected during the test to a lab and will advise you of your results. There are two possible results: normal or abnormal. 

A normal test result means that no abnormal cells were identified. Your doctor will advise you on when your next Pap smear should take place. 

If you receive an abnormal test result, this means that abnormal cells are detected on your cervix. This doesn’t mean you have cancer. Abnormal cells can be precancerous. If abnormal cells are detected, your doctor may perform a procedure called a colposcopy to get a closer look at the cervical tissue.

When should I seek treatment?

If it’s been over a year since your last Pap smear, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor can suggest a women’s health provider who can perform this important screening test.

Abnormal Pap Smears, 7 Things to Know if Your Pap Test is Abnormal  

First, to help ensure you have a normal Pap smear

A Pap smear test (Pap test) checks for abnormal changes to cells in the cervix. This is an important defense against cervical cancer, because early detection of abnormal cells may allow them to be removed before they develop further.

It is optimal to have the Pap test between periods. To help ensure accurate results of your Pap test, avoid the following things during the two days prior to having the test.

• Feminine hygiene products (sprays or powders)
• Vaginal medications
• Vaginal creams and suppositories
• Tampons
• Sexual intercourse

What you should know If your Pap smear is abnormal

There are multiple possible causes of an abnormal Pap smear. Here are some things you will want to know if your doctor advises you that your Pap test is abnormal, including what to expect next, and what you should do.

1. Does an abnormal Pap smear mean you have cancer?

Having an abnormal Pap test outcome does not necessarily mean that you currently have cancer. On the contrary, most abnormal Pap tests are not due to cancer.

2. What does an abnormal Pap test mean?

If your doctor informs you that your Pap smear is abnormal, that simply means that the test detected some cells on the surface of your cervix that do not appear normal.

3. What causes an abnormal Pap test?

Most often, abnormal changes in cells are caused by human papillomavirus (HPV), a sexually transmitted infection (STI). These cell changes usually go away without any treatment. However, some types of HPV have been associated with cervical cancer. This is one reason why having Pap tests routinely is so important for women’s cancer prevention.

In some instances, cell changes are caused by other infections or conditions which can be treated, including these.

• Yeast infection
• Bacterial infection
• Herpes
• Inflammation
• Trichomoniasis

In women who have finished menopause, Pap tests may identify cell changes that appear abnormal, but that are really merely due to aging.

4. What increases the risk of having an abnormal Pap smear?

Some activities or physical conditions can result in an abnormal Pap test, including the following.

• Sexual intercourse without using a condom (HPV risk)
• Multiple sexual partners (HPV risk)
• Having a sexual partner who has sex with other partners (HPV risk)
• Prior exposure to HPV, even years earlier
• Impaired immune system
• Smoking
• While pregnant with you, your mother had exposure to diethylstilbestrol

5. If a Pap test is abnormal, will you have symptoms?

Most changes in cells which cause an abnormal Pap smear do not cause symptoms. HPV, which is the most common cause of abnormal Pap tests, does not cause symptoms. But, other STIs can cause symptoms. The following STI symptoms may occur.

• Itching, pain, or burning in your genital or pelvic area during sex or urination
• A vaginal discharge that is different from what you may normally experience, in color, texture, odor, or amount
• Lumps, sores, blisters, warts, or rashes on or in the area around your genitals

6. If cervical dysplasia is found by the Pap test, does that mean you have cancer?

A Pap smear that indicates a patient has cervical dysplasia means that there are abnormal cells on the cervix (cervical intraepithelial neoplasia). This is not cancer.

The level of cervical dysplasia may be mild or more severe. Additional tests can evaluate the degree of cervical dysplasia that exists.

In most cases, mild dysplasia goes away without treatment. In rare cases, dysplasia has developed into cancer. In severe cases of dysplasia, your doctor can recommend a procedure for removing the abnormal cells.

7. What happens after an abnormal Pap smear?

Your doctor may suggest monitoring your condition by taking a follow-up Pap test to see if there is a recurrence of abnormal cells or HPV.

• Colposcopy — This is examination of the vagina, cervix, and vulva. A view magnifier is used to locate abnormal cells and determine the extent of abnormality.
• Biopsy — A small sample of cells is taken for laboratory testing.
• Human papillomavirus (HPV) test — Your doctor may recommend having this test a year or so after an abnormal Pap smear. (Even after normal Pap smear, having this test every 3 years may be recommended.)

For your OB/GYN care, including Pap test monitoring in Denver

The basis of our OB/GYN practice is compassionate and individualized care for each woman throughout her lifetime. We also believe in forming a partnership with each woman and providing education and information.

Dr. Eule makes herself available 24 hours a day 7 days a week through her answering service. She also crosses patient care coverage with 4 other female OB/GYNs in Denver. If there is a problem or an emergency, a competent female doctor in Denver is on hand to ensure our patients receive prompt help, in the event that she may temporarily be unavailable.

Our highly qualified nurse practitioner, Cathie, is also available to provide our patients with a wide variety of healthcare services.

We enjoy being there for our patients, and we feel honored to be entrusted with their OB/GYN care.

For More Information

If you would like more information about having a Pap tests, or want to schedule a consultation or examination by an OB/GYN physician in Denver, contact our office, Kristine A. Eule, MD, to make an appointment. Our office is located in the Denver Tech Center. We provide women’s health care in a friendly, intimate environment. Our office hours are M-TH 8:30am – 5pm, F 8:30am – 3pm on Friday.

Abnormal Pap Smears, 7 Things to Know if Your Pap Test is Abnormal

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7 things you should know if your Pap smear is abnormal. An abnormal Pap smear (Pap test) does not mean that you have cancer. What does abnormal Pap smear mean?

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Liquid cytology. Examination of scraping of the cervix and cervical canal (Pap test)

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

Russian synonyms

Pap smear, Pap test, smear for oncocytology.

Synonyms English

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

Research method

Liquid cytology method.

What biomaterial can be used for research?

Mixed smear from the cervical canal and the surface of the cervix.

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.

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 HPV 16, HPV 18, HPV 31, HPV 33, HPV 45, etc.), smoking, chlamydial or herpes infection, chronic inflammatory gynecological diseases, long-term use of contraceptives, cases of cervical cancer in the family, early onset of sexual activity, frequent change of sexual partners, insufficient intake of vitamins A and C, immunodeficiency 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 results can be screened every 2-3 years. Women with risk factors (human papillomavirus infection, immunodeficiency states) should continue to be screened annually. Women 65 years or 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.

Liquid cytology – an innovative method of cytological research, ideal for diagnosing neoplasms of the mucous membrane of the canal and the vaginal part of the uterine cervix; it is used when a patient suspects cancer or dysplasia.Thanks to it, you can detect cancer at the earliest stages of development.

After taking a smear for oncocytology, the biomaterial is placed in a liquid medium. With the help of a special centrifuge, cells (cytopreparations) are “washed”, which are concentrated in one place and form an even layer. In this case, the conclusion of a cytologist will be more accurate and informative than in conventional cytology, when the material taken for research is immediately applied to a medical glass for analysis.

The advantage of the PAP test is the high definition of the cell image.When using this technology, the resulting material is mixed with a special solution, which mechanically separates the epithelial cells from contamination. As a result, the number of false negative results is significantly reduced.

Cytological examination of material from the cervix and cervical canal, stained by 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) is examined. Material from the transformation zone should get into the smear, since about 90% of neoplastic conditions come from the junction zone of the squamous and cylindrical epithelium and only 10% from the cylindrical. 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?

• Screening and diagnosis of precancerous diseases of the cervix.
• 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

• Material full (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 scarce.
• 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 are 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 epithelial cells of unclear significance;
• atypical squamous epithelial cells that do not exclude HSIL;
• squamous intraepithelial lesion;
• low degree of squamous intraepithelial lesion;
• high degree of squamous intraepithelial lesion;
• cervical intraepithelial neoplasia of the 1st, 2nd or 3rd degree;
• carcinoma in situ;
• squamous cell carcinoma is invasive carcinoma.

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

• atypical glandular cells;
• atypical glandular cells, similar to 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.

Download an example of the result

Important notes

• In acute infection, it is desirable to obtain material for the purpose of examination and identification of the etiological agent; after treatment, but not earlier than 2 months later, cytological control is required.
• There is a possibility of a negative test result with changes in the epithelium in the cervix, therefore it is important to regularly re-examine and, if the material is taken incorrectly, repeat the test.

Also recommended

• Cytological examination of smears (scrapings) from the surface of the cervix (external uterine pharynx) and cervical canal for atypia
• Squamous cell carcinoma antigen (SCCA)
• Human Papillomavirus of high carcinogenic risk (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 types), DNA without type determination [PCR] (urogenital smear, rectal smear, biopsy)

Who orders the study?

Gynecologist, oncologist.

Literature

• Apgar BS, Zoschnick L, Wright TC (November 2003). “The 2001 Bethesda System terminology”. Am Fam Physician 68 (10): 1992-8.PMID 14655809.
• Arbyn M. et al. (2010). “European Guidelines for Quality Assurance in Cervical Cancer Screening. Second Edition — Summary Document”. Annals of Oncology 21 (3): 448-458.
• American College of Obstetricians and Gynecologists, “ACOG Committee Opinion No. 483: Primary and Preventive Care: Periodic Assessments,” 2011, Obstet Gynecol, 2011, 117 (4): 1008-15.PubMed 21422880.

Cytological examination of smear in MC “Danae”

Cytological research is a method of laboratory diagnostics, which is based on the study and assessment of the state of cells. It helps to notice pathological changes at an early stage, when the symptoms of cancer are not yet manifested, and to choose an effective treatment in a timely manner. Danae MC uses modern standardized technologies that ensure high quality smear for cytology and exclude false results.

Prices for cytology

See all prices

Appointment to a doctor

Why is analysis needed?

Cytological research is a method of laboratory diagnostics, which is based on the study and assessment of the state of cells. It helps to notice pathological changes at an early stage, when the symptoms of cancer are not yet manifested, and to choose an effective treatment in a timely manner.Danae MC uses modern standardized technologies that provide high quality smear for cytology.

Why do we need a cytological examination of a smear (scraping)

Cervical cancer is one of the most common cancers in women. In addition to its prevalence, it also differs in long-term asymptomatic development – it can take up to 15 years from the first cell changes to an obvious manifestation.

Cytology of epithelial scrapings from the cervix and cervical canal is the “gold standard” of research in gynecology.It allows you to detect early changes in the cellular structure and precancerous conditions, atypical cells with signs of malignant degeneration, lesions of low and high degree. Initiation of adequate treatment in the preclinical phase reduces its duration and complexity, significantly reduces the risk of disability, and increases survival.

Kravtsova
Natalya Yurievna

Physician CDL MC “Danae”

Cell studies are relevant not only for the diagnosis of precancer and primary cervical cancer.If neoplasms are suspected, mammary secretions, bronchial washings, smears from the gastrointestinal tract mucosa, sputum, urine, and skin punctures are used as biomaterials for cytology.

Types of cytological studies

A smear for cytology in women can be performed in two ways, which differ in sensitivity and specificity.

• Simple examination of scraping for atypia with traditional smear preparation. Performed with simple dyes, it makes it possible to identify inflammation, infections, signs of changes in the endometrium and endocervix.The sensitivity is 60-80%.
• Liquid cytology with complex Papanicolaou staining (PAP test) and a modern method of obtaining biomaterial. Differs in high information content and reliability in the recognition of pathologies of the endometrium and endocervix, high sensitivity.
• In addition to inflammatory processes and changes in the cell, when taking a scraping for cytology, the flora is studied for the presence of bacteria, fungi, signs of herpes.

Indications for analysis

Cytology, like histology, refers to morphological studies.The key difference is the subject matter. In the first case, the state of epithelial cells is assessed to diagnose the preclinical phase of cancer, and in the second, the structure of tissues obtained by biopsy.

Analysis assign:

• With periodic screening examinations for the prevention and early diagnosis of precancerous conditions.
• In case of suspicion of cervical cancer, to confirm or refute the preliminary diagnosis.
• With conservative treatment to assess the effectiveness of tactics and after it to control the condition.

The frequency of the study is determined by the doctor, based on age, previous test results, existing pathologies, including herpes virus and human papillomavirus, immunodeficiency.

What Cytology Shows

Screening tests are sensitive, reliable, promptly provide information about the state of the epithelium and the presence of other diseases.Results can be obtained within 3-5 days.

Analysis shows:

• Benign changes – the presence of unconditionally pathogenic microorganisms (Trichomoniasis), cocci, rods, fungi, a large number of leukocytes.
• Pathological changes – carcinoma, adenocarcinoma, neoplasia, squamous cell carcinoma and some atypical cells.

Minimal deviations from the norm and atypia of unclear significance require attention, therefore the doctor may prescribe repeated or additional examinations.

If pathological changes are not identified, then in the conclusion they indicate a cytogram without features or within the normal range – material negative in relation to malignancy and intraepithelial lesions.

Rules for submitting biomaterial

For research on oncocytology, a smear (scraping) from the cervix and cervical canal is used.

Before taking the test, you need:

• Refrain from sexual intercourse for 1-2 days before taking the test.
• Refuse douching, the use of spermicides, intravaginal drugs 24 hours before the smear.
• To withstand at least 5 days from the beginning of the menstrual cycle or 2-3 days after the end of the discharge.

The doctor can take a scraping at any time if during the examination he finds a visually identifiable pathology of the cervix.

After a smear for cytology, minor spotting and a pulling sensation in the lower abdomen may appear.They take place in one day.

Where to get tested for cytology in St. Petersburg

Medical centers “Danae” have high-tech laboratories. We offer to take smears for cytology in our clinics in the Kirovsky and Vyborgsky districts of St. Petersburg near the Prospekt Prosvescheniya and Leninsky Prospekt metro stations. You can make an appointment with a doctor, find out the price and how much analysis is done on our website or by phone.

Ask your question

Smear for oncocytology | Medical center “President-Med”

A smear for oncocytology is a microscopic examination of cells taken from the cervix and cervical canal.It allows you to identify abnormal cells of the cervix, conduct further examination, diagnose and prescribe adequate therapy. The analysis is carried out for the early recognition of precancerous lesions of the cervix, endometrium, vulva and the detection of asymptomatic pathologies of the genital organs.

Cervical cancer is often preventable. Changes found on a cytological examination of a smear and indicating that cancer may develop are not a reason to panic. This is a chance to treat the condition in time and prevent the deviation from developing into a malignant tumor.Cervical cancer screening is not a cancer test. It is used to detect early pathologies of the cervix.

Indications for oncocytological screening

Oncocytological smear is indicated for all women and is essential for high-risk patients.

Annual diagnostic test recommended for women since:

• family history of gynecological oncolopathologies;
• high titer of HPV;
• by pseudo-erosion;
• leukoplakia;
• by erosion of the cervix;
• adenomyosis;

90,061 polyps;

• dysplasia;

as well as women over 40

Oncocytological screening – a way to prevent cervical cancer.It detects the presence of changes in cells, which can, if left untreated, develop into cancer.

How is the procedure

Screening is part of the routine gynecological examination and is fast. The procedure is practically painless. The gynecologist collects biomaterial using a soft-bristled cytobrush or a special spatula. First, the doctor inserts and fixes a conventional gynecological speculum, then, by scraping, receives cellular material from the vaginal area of ​​the cervix.Slides with tissue samples are transferred to the laboratory.

Preparation for oncocytological screening

Taking a smear is not recommended for any inflammatory process. It is necessary to first undergo anti-inflammatory therapy, and then screening. A smear should not be “taken” during menstruation.

48 hours before the examination, patients are advised to refrain from sexual activity (vaginal contact). The use of vaginal suppositories, creams is prohibited.A woman cannot take a bath, swim in the pool. Only showers are allowed. Any douching is excluded. If a colposcopy was performed the day before, then 48 hours should pass after the procedure.

Interpretation of the results of an oncocytological test

A smear for oncocytology helps to detect atypical cells with high oncogenic risks. A negative result informs about the presence of normal cells in the studied biomaterial. A positive smear result indicates that abnormal cells are found, which does not mean cancer.Untreated infections can give deviations in the test: chlamydia, gonorrhea, candidiasis and others.

Abnormal cells indicate that cancer may develop sometime in the future. Most of the changes will not lead to cervical cancer. About six percent of patients with abnormal cells will require further examination plus treatment to prevent the risk of developing cancer.

To take a smear for oncocytology for the prevention of cervical cancer, contact President-Med medical centers in Moscow (m.Kolomenskaya, metro VDNKh) and in Vidnoye

Artist: Lavrova Nina Avenirovna

Deputy General Director for Medical

Graduated from the Yaroslavl State Medical Institute with a degree in General Medicine
Medical work experience – 25 years

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Make Pap test – Papanicolaou cytology

Analysis for early detection of oncological changes in the cervix was named after the founder of medical cytology, Georgios Papanikolaou.It is recommended for all girls and women who are sexually active. In case of negative PAP results, the study can be carried out once a year. If a woman is at risk, then Papanicolaou cytology is performed by a doctor more often, depending on the specific clinical case. The factors that provoke the development of cervical and vaginal cancer include:

1. Identification of HPV types in the body that have a high oncogenic risk.
2. Smoking.
3. Immunodeficiency diseases.
4. Frequent genital infections.
5. Hereditary predisposition, that is, the presence of cancer diagnoses of the reproductive system in relatives.

It is also important to know that women who have more than 4 sexual partners in their entire life are at risk of developing cervical cancer.

The PAP test is a simple but effective method for the early detection of many gynecological diseases, including cervical cancer.

How to prepare properly?

To obtain a reliable result 3 days before the study, adhere to the following recommendations:

• do not use vaginal preparations: suppositories, creams, tablets;
• do not use tampons;
• do not douche;
• Observe sexual rest.

Come to the gynecologist for examination!

In a medical center with a European approach, the French Clinic, you can complete this study in a comfortable environment and as quickly as possible. Our experienced gynecologists will provide detailed advice based on the analysis results.

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The clinic administrator will call you back.

Cytology pap test is prescribed in the middle of the cycle, but no later than 5-6 days before the onset of menstruation.Also, if you underwent a vaginal ultrasound or colposcopy, then at least 2 days after the procedure should pass. Contraindications are bleeding and exacerbation of gynecological diseases.

Procedure

This test is simple and is carried out by a doctor in an office setting. It does not require pain relief or hospitalization.

1. The woman is in the gynecological chair.
2. A gynecologist, using a vaginal speculum, examines the genitals.
3. Using a special cytological brush, the doctor makes a scraping from the outer surface of the cervix and cervical canal. Particular attention is paid to places where there are pathological changes in the mucous membrane.
4. The obtained biomaterial is applied to a glass slide and fixed with an alcohol-containing solution. Or, together with a removable brush, it is placed in a container with an aqueous solution (liquid cytology).
5. Sent to the laboratory.

The procedure takes no more than 5-7 minutes.After analysis, no discomfort or discomfort is usually observed. In rare cases, short-term scanty spotting from the genital tract is possible.

What diseases does it detect?

The main goal is to identify cancer cells and precancerous changes in the cervix. The analysis also reveals inflammatory changes and dysbiosis. The price of the PAP test depends on the method used and the timing of the result. Sign up for a consultation at the French Clinic to clarify the cost of the analysis.

Frequently Asked Questions

1. At what age is it recommended to take this test?

The PAP test must be done after the onset of sexual activity, then once a year in the absence of pathology.

2. The partner was diagnosed with HPV. Do I need to take a dad test?

If your partner has a virus, first of all, you also need to take a smear for HPV. The Pap test will allow you to control the situation and, if necessary, begin treatment.

3. Do I need to take a smear if I do not have ectopia?

This analysis is performed on all girls from the beginning of sexual activity. In addition to erosion, there may be other pathological phenomena on the cervix, which for years can go unnoticed for a woman.

Even if nothing bothers you.

A visit to a gynecologist for every civilized woman is not just a visit for pregnancy or ailments, it is a mandatory preventive examination every six months.There can be many reasons for a visit to a doctor in women: choose the right contraceptive, get tested for infections, detect inflammation in time, or find other, more serious problems. But in every case, the visit is not complete without smears. What are they needed for? How to prepare for them?

Flora or gynecological smear

A smear on flora can tell a lot. First of all, the number of leukocytes is determined. If there are a lot of white blood cells, then you may have inflammation.Also in this smear, the type of microflora is determined. It is directly related to the phase of the menstrual cycle. In the analysis, there may be different cells of the rod or cocci. If there is inflammation, then there will always be a lot of cells, since they are rejected faster. Key cells may appear –

this also suggests that it’s time to take care of your health. When gonococci or Trichomonas appear in the analyzes, then you definitely shouldn’t postpone the visit to the doctor. If filaments of mycelium are found in your smear on the flora, then this is a characteristic symptom of candidiasis, in other words, “thrush”.

Before visiting a gynecologist for testing, you should: refrain from sexual intercourse for 1-2 days; do not use vaginal preparations (creams, suppositories) and do not douche for 2 days; before taking a smear on flora, it is recommended not to urinate for 2-3 hours. It is advisable to take a smear on the flora immediately after menstruation.

Sterility smear

At the reception of a gynecologist, you can take a smear for the degree of purity and for hormonal levels.It determines the composition of the contents of the vagina, which is normally represented by secretions, epithelial cells and various microflora. The degree of purity in the smear results is expressed in numbers: 1 and 2 are indicators of health, and 3 and 4 indicate the presence of colpitis – inflammation of the vagina. There is also a smear for hormonal levels. It shows how sex hormones – estrogens and progesterone – affect the female body during the menstrual cycle. Based on its results, it is possible to establish how correctly and in what quantity they are produced.A variant of this smear is the Threat Smear -KPI. It is used during pregnancy to determine the risk of termination.

Smear for cytology, or Pap test

Pap smear, or Pap test, is needed in order to identify abnormalities in the cells of the cervix. In our country, it is also called a smear for atypical cells or for cytology. These are all “names” of one analysis. A Pap smear should not be taken during menstruation or if there is inflammation, as the result may be false.During the day, as in the case of taking a smear for flora, you should avoid intimacy, do not use candles or tampons. In a cytological smear, the size, shape, number and nature of the location of cells are assessed. In young girls, this analysis can be used to assess the correctness of the production of estrogen. A smear is considered normal or negative when all cells are of normal size and shape, and correspond to the site of collection, there are no abnormal cells. If atypical cells are detected, an oncologist’s consultation is necessary.An abnormal smear does not always mean that a woman has cervical cancer. When the cells become inflamed, they can also look abnormal. But after treatment, the smear usually returns to normal.

Smear for latent infections

These smears are used to detect infections that are not detected in the study of flora. These include chlamydia, ureaplasma, mycoplasma, genetic herpes, papillomavirus and cytomegalovirus infections. There are quite a number of different methods for diagnosing such infections.The most reliable method is PCR – polymerase chain reaction, in which the infection is determined by its DNA.

The collection of smears from women is carried out, if possible, during the period outside of menstruation. It is not recommended to use douching, as well as any vaginal means: suppositories, ovules, you should refrain from taking antibacterial drugs (antibiotics and antiseptics), both inside and in the form of local instillations, and sexual intercourse 24 hours before the study.

Culture for flora with determination of antibiotic susceptibility

There are two main types of flora culture and antibiotic susceptibility testing:

• culture for flora with determination of sensitivity to the main spectrum of antibiotics,
• culture for flora with determination of sensitivity to an extended spectrum of antibiotics.

Sowing on flora with the determination of sensitivity allows you to identify the causative agent of the disease, as well as select the most appropriate antibiotic. This will correct the chosen therapeutic course, and also, possibly, reveal the reason for the ineffectiveness of the previous course of treatment.

Ulyanova Saniya Muzagitovna – obstetrician-gynecologist, doctor of the highest category, chief physician of the Tet-a-Tet Medical Center.

Vaginal cytology smear.Oncology

Vasiliy Koval / Shutterstock

• Doctors
• The article was updated: June 18, 2020

Background, precancerous and cancerous diseases of the cervix are diagnosed by the size, shape, number and location of cells.

Vaginal cytology smear (Pap smear, Pap test, abnormal cell smear) is a laboratory microscopic examination to detect abnormalities in the cervical cells.

What does a smear show for cytology?

In a cytological smear, the size, shape, number and nature of the location of cells are assessed, which makes it possible to diagnose background, precancerous and cancerous diseases of the cervix.

What are the indications for taking a smear for cytology?

This analysis is prescribed to all women from the age of 18 once a year, as well as for:

• planning pregnancy;

90,061 infertility;

90,061 menstrual irregularities;

90,061 genital herpes;

90,061 obese;

• human papillomavirus;

90,061 taking hormonal contraceptives;

• a large number of sexual partners.
• before setting the intrauterine device;

How to prepare for the study?

Before visiting a gynecologist for tests, you should:

• refrain from sexual intercourse for 1-2 days;
• do not use vaginal preparations (creams, suppositories, lubricants) and do not douche for 2 days;
• before taking a smear for cytology, it is recommended not to urinate for 2-3 hours;
• It is not recommended to take a smear for cytology in the presence of symptoms such as itching and vaginal discharge.

It is advisable to take a smear for cytology immediately after menstruation, on the 4th-5th day of the cycle.

How is a cytology smear performed?

A smear is taken during a gynecological examination with a special disposable small brush from the outer and inner surfaces of the cervix. The smear procedure is painless and takes 5-10 seconds.

Can there be any discomfort after taking a smear for cytology?

Since the doctor makes a scraping during the collection of cells, some may have minor spotting spotting from the vagina within 1-2 days.

How many days to prepare a smear for cytology?

1 working day.

How is the cytology smear evaluated?

A smear is considered normal or negative when all cells are of normal size and shape, and abnormal cells are absent.

To describe a smear for cytology, doctors use special terms: dysplasia 1, 2, 3 degrees, atypia. In case of grade 1 dysplasia, it is necessary to repeat the study after 3-6 months.

What to do if abnormal cells are found in a smear for cytology?

In this case, the doctor recommends an additional examination. This can be as simple as repeating the smear test for cytology some time after the first result. Sometimes colposcopy with a biopsy of the cervix is ​​prescribed to clarify the diagnosis, based on the results of which a decision is made on the method of treatment.

Liquid cytology. Cytological examination of scraping of the cervix and cervical canal (Papanicolaou staining, NovaPrep ® technology)

Study material
smear of the epithelium of the mucous membrane of the cervix and cervical canal

Method of determination
liquid cytology NovaPrep® technology.

LIQUID CYTOLOGY NovaPrep® – THE STANDARD FOR CYTOLOGICAL EXAMINATION OF CERVICAL BIOMATERIAL

CERVICAL CANCER (CC) is the second most common type of cancer among the female population, from which more than 250,000 women die each year worldwide. According to estimates by the World Health Organization, over the next 10 years, mortality from cervical cancer will increase by another 25%. *

The process of cervical cancer development is long.The period from low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) to invasive cervical cancer can be 10-15 years. This means that women have enough time to carry out appropriate preventive measures to prevent the development of invasive cervical cancer.

To identify precancerous changes that, if untreated, can lead to the development of cancer, cytological screening for cervical cancer is performed – testing of all women, most of whom do not show symptoms (cytological examination of biomaterial from the cervix (Pap test, Rar test) ).

Liquid cytology is a standardized technology for the preparation of a cytological preparation. Today it is recognized as the most informative method for obtaining biological material and is recommended as the “gold standard” for the diagnosis of intraepithelial neoplasia from the mucous membrane of the cervical canal and the vaginal part of the cervix and for issuing the result in accordance with the Bethesda classification.

Benefits of liquid cytology

1. Improved material quality:

• all the obtained epithelial-cellular material gets into the container with the stabilizing solution;
• minimizes the content of mucus, elements of peripheral blood, elements of inflammation, destroyed cells;
• cells retain both morphological and molecular biological properties.

Thus, in comparison with the traditional method of preparing a smear from the mucous membrane of the cervix, the use of the new technology of liquid cytology can significantly improve the quality of the cytological smear.

The main disadvantage of a cytological examination of a traditional smear from the cervix is ​​a large proportion (up to 20-40%) of false-negative conclusions. Errors of the cytological method in more than 60% are caused by violations of the procedures for taking and preparing material for research.The main reasons for the inadequacy of a cytological preparation prepared in a traditional way are an insufficient amount of epithelial-cellular material in a smear, an uneven distribution of biological material on the glass, a high content of mucus, elements of inflammation, elements of peripheral blood, a high frequency of artifacts due to the drying out of the preparation after taking a smear (failure rules of wet fixation), incomplete staining of the cellular material due to its multilayer nature (thick smear).

The recently introduced technology of liquid cytology is a standardized technology for the preparation of a cytological preparation (one of the ways to standardize the preanalytical stage of a cytological study).

The use of liquid cytology technology allows to reduce the number of false results due to the use of a stabilizing solution, as well as a special instrument for sampling, the Cervex-Brush (Fig. 1)

Limitations of the liquid cytology method

In thin-layer smears prepared by the LC method, there are no background elements, which improves the quality of the preparation, in terms of cell assessment, but at the same time does not make it possible to assess the cellular environment.In addition, a cytologist cannot evaluate the drug from the point of view of the inflammatory process (the presence of leukocytes, microflora, etc.).

NovaPrep®

NovaPrep TECHNOLOGY FEATURES:

1. New container format for cell material and automatic processors for transferring cells to slides with different capacities.
2. The NovaPrep container differs from other containers (ThinPrep, ThreePath, CYTOScreen, etc.) by the ability to work with cellular material when the lid is closed (the lid contains a hole closed by a rubber plate).There are ribs on the inside of the container that allow you to easily separate the brush of the combination brush and leave it inside the container. In addition, the container contains a 300 micron filter that separates mucus and blood cells and inflammatory cells from diagnostically important cells.
3. The processor in combination with the NovaPrep containers allows to obtain in automatic mode smears of cells with a diameter of 19 mm with a clear and reproducible picture.
4. The advantage of the NovaCyt processor lies in the absolute standardization of the produced smears, provided by the double sedimentation technology: there are no forced filtration or centrifugation steps at all.The processor implements a procedure for filtering, concentrating and diluting cells, completely preserving the morphology and volume of cells.
5. The processor has additional equipment for obtaining material for subsequent analysis of the contents of containers for human papillomavirus, PCR analysis and much more.