Doctors are armed with a barrage of fancy fluoroscopy tables, IV bags, and other instruments that help diagnose you, but an accurate diagnosis also depends on the information you provide. When it comes to pap smears, being honest with your doctor about your sexual history can affect the course of treatment. Four out of five Americans do not provide important information to their doctor that may be essential to their health, so be frank with your medical provider and prepare for your next pap smear the right way.
What is a Pap Smear and What Does it Test For?
A pap smear is a semi-regular test that examines the cervix for signs of cancerous cells. The pap smear occurs during a pelvic examination in which the doctor inserts a speculum into the vagina to remove cells from the cervix. The cells from your cervix are then sent to a laboratory for testing. The test can also detect the presence of HPV, which is sometimes, but not always, a precursor to cervical cancer (of the 100 types of HPV, only 14 are cancer-causing).
Every woman’s medical history is different and affects her susceptibility to developing cervical cancer. Doctors recommend pap smear screenings beginning at the age of 21, especially in women who are sexually active, to prevent any possible HPV infection from developing into full-blown cancer.
Testing every 3 years is sufficient for most women, but those with the following risk factors should consider more frequent testing:
- An earlier diagnosis of cervical cancer
- A pap smear with signs of cancerous cells
- A weakened immune system due to HIV infection, chemotherapy, or an organ transplant
- A history of smoking
- Exposure to toxic DES in the womb
Avoid scheduling your pap smear around the time of your menstrual cycle as that could affect your results. Do not use any products in your vagina and avoid douching and sexual intercourse prior to examination as well.
Getting the Results
Your doctor will notify you of the results from your exam within a few days. If the results of your exam are negative, you don’t need to take any further action.
Should the doctor note anything of concern in your results, there are a few possibilities for how to proceed depending on the type of abnormal cells found. Here are a few possible types of cells your doctor may encounter:
- Atypical squamous cells of undetermined significance: If you test positive for these types of cells, your doctor may refer you for a colonoscopy for further testing. They could also suggest follow up pap smear tests at 4 to 6 month intervals to determine the presence of a possible, though unlikely, high-grade squamous intraepithelial lesion (only 5%-10% of women are diagnosed with these lesions at follow up pap smears).
- Atypical glandular cells: The cervix is lined with these cells which produce mucus. If these cells are detected, another pap smear will determine whether they are pre-cancerous.
- Adenocarcinoma cells: Abnormal cells that almost certainly mean a cancer diagnosis. Adenocarcinoma cells form in mucus-secreting membranes over the body including in the cervix, lungs, prostate, and esophagus.