The Pap Smear 
Do you really need to have one every year?

Most of us have been told that we should have a Pap smear annually.   But how many of us actually do?   Isn’t every two or three years enough?   Is it really that important to have one every year?  

The answer is yes!   You should have a Pap smear every year.  Why?   Well, let’s review what a Pap smear is.

A screening tool proven to be effective

The Pap smear is a safe, painless screening tool for cervical cancer.   It is easy, quick and relatively inexpensive to perform.   The test is valuable because it can detect cancer very early, when it is potentially 100 percent curable.

Since its development in the 1940’s the Pap smear has been used regularly by ob/gyns, and the death rate from cervical cancer has dropped by nearly 70 percent.   But many women still postpone Pap smear screenings for several years or indefinitely. 

It is estimated that 500,000 cervical cancers will be diagnosed this year worldwide, representing 12% of all cancers diagnosed in women and almost half will die from their cancer.

Pap tests provide a close look at the cervical cells

The cervix is the narrow end or tip of the uterus. (It is not a separate organ).  In the Pap smear, a sampling of cells is taken.  First, a small plastic spatula is used to take a scraping of cells from the surface of the cervix and vagina.  Next a tiny brush is swirled inside the cervix to pick up cells in the endocervical canal.   The sample is placed in the Thin Prep Pap.   It is an improvement of the traditional Pap smear.   As a result, the lab can process a higher quality slide to read.

Results are Reported in 5 Categories

Pap smear results may range from normal, healthy cells to advanced cancer of the cervix.  A pathologist or cytologist analyzes the results and reports them in one of five different categories.

Normal:  All cells appear normal.

Atypical squamous cell:   There are many normal cells but some cells have an abnormal appearance of undetermined significance.

Squamous Intraepithelial Lesions (SIL) – Low grade lesions that are suspicious of cancer:   There are more abnormal cells present.   This condition is not cancer, but may develop into very early cancer of the cervix.

Squamous Intraepithelial Lesions (SIL) – High grade lesions that are possibly cancer:The cells are even more bizarre and irregular in appearance.   This is an advanced precancerous stage.

Squamous Cell Cancer:  These cells appear cancerous and usually indicate extensive, invasive disease.

There is one more classification of Pap smears, called “Unsatisfactory Specimen.”  This means the Pap smear could not be analyzed due to:   atrophy (not enough cells), the presence of blood or a foreign material (spermicide, medicated cream, lubricants, etc.), inflammation, or a variety of other reasons.  This classification requires a repeat Pap smear.

Abnormal Results are Further Diagnosed

It’s important to remember that the Pap smear is just a screening, not a diagnostic test.  It tells your physician that a potential problem may be developing and needs further investigation.   Depending on the classification of the result, a series of diagnostic tests may be used.

An atypical smear result or reports falling in the SIL to squamous cell cancer range will require additional procedures for diagnosis and treatment.   Because of new advances in medical technology, the tests available today are more effective, less expensive and less inconvenient than in the past.  Most of them can even be performed in the doctor’s office.

Pap Smears Are Recommended by Experts

Recently, the American Cancer Society, the National Cancer Institute, the American College of Obstetricians and Gynecologists, the American Medical Association and several other national health organizations came to a consensus on how often women should have a Pap smear.   Their recommendation:  all women 18 years (younger if sexually active) and older should have a Pap smear every year.   Even women who have had hysterectomies may still benefit from regular pelvic exams and periodic Pap smears, which can also detect other problems, such as pelvic infections, endometriosis and ovarian tumors.

Why you should have one every year

There are three reasons why annual Pap smears are recommended.

Reason #1   In the early stages, cervical cancer has few, if any symptoms.   There is no pain or discomfort.   You can’t feel or see the cancer developing.   Diagnostic procedures are needed to detect cancer at this stage.   And this is when it is potentially curable.   The more advanced the development, the more difficult and less effective the treatment.

Reason #2   The Pap smear screening is not completely accurate.   It can sometimes yield a false negative (normal) result.   Errors can occur due to a number of factors including patient cooperation*, the method and quality of obtaining the cells, handling and staining techniques in the laboratory, proficiency of the technician and pathologist and the effectiveness of the quality assurance program in the laboratory.

Because cervical cancer is slow to develop, annual screening can also reveal errors and provide more accurate results.

*There are certain things you can do to increase accuracy.   Do not have sexual intercourse, douche or use any vaginal suppositories or products for two to three days prior to your Pap smear.   It is also preferable, but not required, that the Pap test is not during your period.

Reason #3   Your annual visit is a lot more than just a Pap smear.   It is a health maintenance screening in which other health problems such as high blood pressure, elevated cholesterol and triglycerides, diabetes, breast cancer and uterine abnormalities may be detected.   The visit is also an opportunity to receive advice and encouragement for developing healthy lifestyle habits such as preventing osteoporosis, promoting good nutrition and exercise, etc.  

A Pap smear could save your life

If you’ve been putting off your annual Pap smear, or are considering waiting another year, here’s one last thing to think about.   Diagnosis becomes increasingly more complex, more invasive and more painful as the disease progresses.   Treatment also becomes more involved, more time consuming and less effective.

So simple, a painless procedure.   It really is worth the effort!