What exactly is doctor looking for when takes a pap smear?

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Queenet
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What exactly is doctor looking for when takes a pap smear?

Unread post by Queenet »

Gina asks: what does a pap smear tell the doctor?

If you’re a woman, the term “Pap smear” probably makes the hairs on the back of your neck stand up. The very thought of putting the appointment on your calendar makes little beads of sweat begin to form on your forehead. Similar to getting a prostate exam, this test, while necessary, can be both uncomfortable and force you to break down all the walls of modesty you possess.

Named after Dr. George N. Papanicolaou, who, in 1928, found that cancer cells in vaginal smears could help Doctors find early stages of cervical cancer. The procedure, also known as cervical cytology, involves a women lying on the exam table in stirrups. The doctor places a tool, known as a speculum, into the vagina. The speculum then expands and allows the doctor a better view of your cervix. They then scrape away cells, put them on a glass slide and send them off to the lab for analysis. The pathologist looks at what are known as squamous cells to see if they’re normal, or possibly pre-cancerous.



The test, at first, was not taken seriously by many in the medical profession, most likely because Dr. Papanicolaous’ first study on the topic was full of typos and inaccuracies. In 1941, he did a much better job on a paper published in the “American Journal of Obstetrics and Gynecology”. The theory was then embraced by OB-GYN’s and the American Cancer Society, who started promoting the test. It has become so popular, as of 2005, 86% of women age 18-64 had at least one Pap test in the previous 3 years. Forty years ago cervical cancer was the leading cause of cancer deaths among women. Thanks to this screening technique, those death rates have decreased dramatically, though in 2008, it was still the third leading cause of cancer in women, accounting for 8.8% of cancers.
What doctors are looking for are abnormal squamous cells. Unlike other cells in the body that are square (cuboidal) or rectangular (columnar), these cells are flat. Coming from the Latin word “squamosus”, meaning scales, they resemble the scales on reptiles. These types of cells are found in numerous areas of the body, like the mouth/lips, in the outer layer of your skin (epidermis), and on the cervix. Any squamous cell can become cancerous. In fact, Squamous cell carcinoma accounts for 20% of all skin cancers.

When the pathologist looks at the cells from your cervix to determine your risk of cancer, they use a system known as the “Bethesda System” (named after Bethesda, Maryland where it was developed). Depending on how the cells look, they put them in 5 main groups:

Within normal limits. The cells look normal.
  • Atypical Squamous Cells of unknown significance (AGC). The cells are mostly normal but some have unusual shapes, colors or sizes.
    Low-grade squamous intraepithelial lesion (low-grade SIL). Some abnormal cells but cancer is rare.
    High-grade squamous intraepithelial lesion (high-grade SIL). There are a large number of abnormal cells.
    Atypical Squamous cells (ASC). You probably have cancer, but they will double check.
If your doctor gets the test results back and it falls into any category other than “within normal limits”, they may choose to do follow-up pap smears, or colposcopy (taking a magnified look at the cervix). They could also perform DNA testing to look for high-risk types of human papillomavirus (HPV).

HPV is the most common type of sexually transmitted disease. The CDC reports that approximately 50% of the US population will be infected by one of these viruses in their lifetime. It has been shown that approximately 30 of the over 100 types of HPV cause cancer. In 2000, the FDA approved a test to detect the DNA of HPV, and in 2006 a vaccine for the virus was approved.


This knowledge has led some people to think the Pap smear, as a means of detecting cervical cancer, will be phased out over time. This idea is extremely controversial. Currently most doctors use the Pap smear in conjunction with an HPV test, or carry out HPV testing if the Pap smear comes back abnormal. The controversy over how to use HPV testing in conjunction with Pap smears will remain for years to come. Time will tell what common practice will be, but I’m sure most women won’t mind not having that cold instrument shoved in there special “no-no” region.


If you do get diagnosed with cancer, you will be put in one of 5 categories, 0-4.
  • Stage 0 means your cancer cells are on the surface of your cervix and do not invade deeper

    Stage 1 (is further broken down in 4 classes) means your cancer has invaded deeper into the cervix but still just remains there.

    Stage 2 (further broken down in 2 classes) means the cancer has spread to nearby tissues but remains in the pelvic area.

    Stage 3 (also broken down in 2 classes) means your cancer has spread into the lower portion of your vagina, and possibly to the pelvic wall.

    Stage 4 (also broken down in 2 classes) means your cancer has spread to other parts of the body. If you are diagnosed with stage 4, you have the most advanced stage of cancer and have a poor prognosis. This is one result that the lower the number the better off you are.

    While the Pap smear can be uncomfortable and make you feel a bit embarrassed, get one- especially if you are sexually active! It might just save your life. Since we mentioned it at the beginning…. boys, get a prostate exam as well! (If you’re over 40 that is.)

Bonus Facts:
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The American Cancer Society recommends that a woman should get a Pap smear at least once a year. They do go on to say, if you get the liquid-based version of the test, or you are over 30, you can have one every 3 years, as long as you have had three consecutive normal tests.
90% of cases of HPV are cleared by your body’s immune system within two years. If they are not, some can cause genital warts, or warts in the throat, known as recurrent respiratory papillomatosis. If you do get these warts, you can always look on the bright side. The types of HPV that cause warts are not the same as the ones that cause cancer!

HPV viruses can also cause cancer of the vulva, vagina, penis, anus, and areas of the mouth including the tongue and tonsils.

Doctor Papanicolaou received his medical degree from the University of Athens, Greece in 1904. Before he changed the way we test for cervical cancer, he chose to get his doctorate in zoology from the University of Munich, Germany in 1910. The discovery of the benefits of his procedure were an accident. While developing a vaginal smear that was intended to track reproductive cycles, he began to notice cancer cells. So the idea to make women everywhere uncomfortable was born. Uncomfortable, but alive! He died February 19, 1962 from an apparent heart attack.


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Re: What exactly is doctor looking for when takes a pap smea

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How to Reduce Your Risk of Cervical Cancer

Cervical cancer is one of the most preventable types of cancer. Because of the Pap smear test, the number of cervical cancer cases has dropped over the past twenty years. However, many women still develop cervical cancer. In fact, over 9,000 women in the U.S. develop cervical cancer every year.

While some cases of cervical cancer cannot be prevented, there are many things a woman can do to reduce her risk of developing cervical cancer.



Get a regular Pap smear. The Pap smear can be the greatest defenses for cervical cancer. The Pap smear can detect cervical changes early before they turn into cancer. Check cervical cancer screening guidelines to find out how often you should have a Pap smear, or check with your doctor.

Limit the amount of sexual partners you have. Studies have shown women who have many sexual partners increase their risk for cervical cancer. They also are increasing their risk of developing HPV, a known cause for cervical cancer.

Quit smoking or avoid secondhand smoke. Smoking cigarettes increases your risk of developing many cancers, including cervical cancer. Smoking combined with an HPV infection can actually accelerate cervical dysplasia. Your best bet is to kick the habit.

If you are sexually active, use a condom. Having unprotected sex puts you at risk for HIV and other STD's which can increase your risk factor for developing cervical cancer.

Follow up on abnormal Pap smears. If you have had an abnormal Pap smear, it is important to follow up with regular Pap smears or colposcopies, whatever your doctor has decided for you. If you have been treated for cervical dysplasia, you still need to follow up with Pap smears or colposcopies. Dysplasia can return and when undetected, can turn into cervical cancer.

Get the HPV vaccine. If you are under 27, you may be eligible to receive the HPV vaccine, which prevents high risk strains of HPV in women. The HPV vaccine, Gardasil, was approved by the FDA to give to young girls as young as 9. The vaccine is most effective when given to young women before they become sexually active.
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Re: What exactly is doctor looking for when takes a pap smea

Unread post by Kunle Emmanuel »

JANUARY is Cervical Cancer Awareness month
Ladies please remind those around you that routine pap smears have increased cervical cancer survival by 70%. If they don't check it they cannot detect it.

Prevention and diligence can tremendously reduce the chances of developing cervical cancer.

cervica1.jpg
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Re: What exactly is doctor looking for when takes a pap smea

Unread post by Kunle Emmanuel »

How to Prepare for Your Pap Test
You should not schedule your Pap test for a time when you are having your period. If you are going to have a Pap test in the next two days—

You should not douche (rinse the vagina with water or another fluid).
You should not use a tampon.
You should not have sex.
You should not use a birth control foam, cream, or jelly.
You should not use a medicine or cream in your vagina.
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Re: What exactly is doctor looking for when takes a pap smea

Unread post by Kunle Emmanuel »

Cervical cancer causes more premature deaths than any other malignancy in the developing world. The availability of screening and treatment can prevent so many of these unnecessary deaths.

Every year millions of women around the world are diagnosed with changes to the cells on their cervix, these changes are called pre-cancer. A further half a million women each year are diagnosed with cervical cancer. Both cervical cancer and cervical pre-cancer are fully treatable.

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Re: What exactly is doctor looking for when takes a pap smea

Unread post by Royston »

Hello ,

For women , Doctor may ask if you are pregnant or has past pap smear problem .
Its a screening test for cancer. it may discomfort you and can cause little bleeding.
Everyone should be checked every 3 years for any cervix cancer signs
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Re: What exactly is doctor looking for when takes a pap smear?

Unread post by Kunle Emmanuel »

Cervical cancer starts with a virus: HPV (human papillomavirus).

The HPV test can identify high-risk HPV before cancer develops.

Know the Facts: HPV + Your Health

• The human papillomavirus (HPV) is transmitted through sexual intercourse or direct genital contact with an infected partner.

• Even if you’re not currently infected with the virus, chances are you have been. An estimated 75 to 80 percent of adults (men and women) have had the virus by the time they are 50.

• Most of the time, your immune system fights off the virus just as it does a cold or flu virus. In fact, 75 to 90 percent of HPV infections disappear within a year.

• High-risk HPV infections do not cause symptoms, and cervical cancer often does not cause symptoms until it is at a very advanced stage.

• High-risk HPV can only be detected with an HPV test.

What does a positive HPV test result mean?
• First, it does not mean you have cervical cancer.
• If your Pap test is normal but you have HPV, your health care provider canmonitor you so that any cell changes can be caught early, before they causeproblems.
• If you test positive for HPV two times in a row, even if your Pap test is normal,you will need additional tests.
• While there is no way to get rid of the virus itself, the abnormal cells can betreated, preventing them from becoming cancerous.

Preventing Cervical Cancer:
An Ages and Stages Guide
Protect yourself against cervical cancer by knowing which prevention strategy to choose and when.

Here’s a quick look:
HPV Vaccine:
• Highly effective in protecting against the most common types of HPV that cause 70 percent of cervical cancer.
• Recommended for girls ages 11 and 12, although it is approved for girls and young women ages 9 to 26. Ideally, the vaccine should be given before a girl or woman becomes sexually active.
Pap Test:
• Evaluates cells from the cervix for abnormalities, including precancerous and cancerous changes.
• Women 21 and older should have Pap tests regularly.

HPV Test:
• Detects the high-risk types of HPV that can cause cervical cancer before cervical disease or cancer develops.

• When combined with a Pap test, the HPV test is better at identifying women at risk for developing cervical cancer than the Pap test alone.

• Recommended for women 30 years of age and older. Identifying the virus in younger women wouldn’t be helpful because HPV is so common and cervical cancer so rare in younger women.

If you are age 30 or older, schedule your HPV test today!
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Re: What exactly is doctor looking for when takes a pap smear?

Unread post by Kunle Emmanuel »

How should the HPV vaccine to prevent cervical cancer be taken?
Does it cover for life?


HPV vaccine schedule
At 9 -15 years, two doses at 0 months & 6months

At above 15 years, three doses, at 0 month, 1 months & 6 months

It is a once in a life vaccination
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Re: What exactly is doctor looking for when takes a pap smear?

Unread post by Christy »

Make sure you get a Pap test to check for cervical cancer every 3 years if you are 25 or older. If you are 30-65, you can get both a Pap test and HPV test every 5 years.

Older than that, you may be able to stop testing if your doctor says you are low risk.
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Re: What exactly is doctor looking for when takes a pap smear?

Unread post by Christy »

If you are sexually active and have a higher risk for STDs, get tests for chlamydia, gonorrhea, and syphilis yearly. Take an HIV test at least once, more frequently if you’re at risk. Don't skip your yearly checkup.
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