Pap smear: What is it and When should it be performed?

Pap smear test is a test that probably every woman has heard of. It plays a key role in detecting neoplastic changes in the cervix. Their early detection enables a quick reaction, appropriate treatment or taking measures preventing the further development of changes. Finding cervical cancer at an early stage of its development that is not yet symptomatic increases your chances of full recovery.

Pap smear test — what is it?

Cytology, i.e., a cervical smear, also known as a 'Pap test', is a gynecological examination performed by taking a sample from the cervix. Its use allows for the early detection of cervical cancer and is an important element in the prevention of this cancer.

Pap smear — what does the procedure look like?

A pap smear test is most often performed as part of a standard gynecological examination and it’s done before performing a transvaginal ultrasound. In order to collect the sample, a gynecological (vaginal) speculum is used. It makes it possible to tilt the posterior and anterior walls of the vagina from each other in order to show the cervix surface. Then, with the help of a special brush, epithelial cells are collected from the vaginal canal. After securing it, the sample is sent to the laboratory.

What does Pap smear detect?

Pap smear plays a very important role as an element of the diagnosis of neoplastic diseases in the early stages of development. With the help of this test, it is possible to detect cervical cancer at an early stage. In addition, cytology allows the detection of the human papillomavirus (HPV), variants of which are closely related to the occurrence and development of certain neoplasms.

When is the best time to get a Pap smear test?

It is recommended to perform it regularly as a prevention of cervical cancer. Ideally, it should be repeated annually, and if the previous results were correct, they can be performed at longer intervals, but at least every 3 years.

Cytology can also be performed on a virgin, but you should inform about this fact before performing the examination. In this case, other, smaller tools are used, and the examination is carried out with particular delicacy. Moreover, it is a study that is one of the mandatory tests during pregnancy. The swab is taken if more than 6 months have passed since the previous examination.

A large proportion of women mistakenly assume that cytology is no longer necessary after the menopause and often give it up, avoiding visits to the gynecologist at the same time. Many factors can influence the development of cervical cancer, some of which may also affect older women. The decision to withdraw from Pap smears should be consulted with a gynecologist.

Pap smear test — how to prepare?

Some factors can affect the Pap smear test. Therefore, you should remember about proper preparation. What should you remember about?

• The swab can be taken at least 2 days after the end of the menstrual period and at the latest 4 days before the next one.
• The best time to take a smear is in the first half of the cycle.
• For 4 days before the cytology, you should not take vaginal medications, use tampons and irrigate.
• You should give up sex at least 24 hours before the examination.

Moreover, it is recommended that intimate hygiene cosmetics should be avoided 2 days before the examination. The final result of the cytology may be disturbed by bathing, for example, in a swimming pool, where there is a risk of a change in vaginal pH.

Pap smear — results

The cytology results are compiled on the basis of the Bethesda classification. The correct result is marked as NILM, which stands for “no intraepithelial lesion or malignancy”

The following signs indicate a negative result:
ASC (atypical squamous cells)
Atypical squamous epithelial cells that indicate the presence of inflammation do not mean neoplastic changes at this stage. This group includes:

• ASC-US — atypical squamous cells of undefined meaning;
• ASC-H — atypical epithelial cells, where the presence of HSIL changes cannot be excluded;

SIL (squamous intraepithelial lesion)
Intraepithelial lesions, meaning the presence of more or less cells from which to develop neoplastic lesions. This group belongs to

• L-SIL, i.e., small changes in squamous epithelial cells, usually resulting from infection by the HPV virus. Also known as CIN1;
• H-SIL, that is, unfortunately, large changes in squamous epithelial cells, also referred to as CIN2 and CIN3;

AGC (atypical glandular cells)
Atypical changes in glandular cells, including the following results:

• AGUS — abnormal glandular cells difficult to interpret,
• AGCN — oncologically suspected cells;

Some specialists relate the above classification to the Papanicolau classification that was used earlier. According to her, the result can be classified into one of 5 groups:

• Group I — normal result, no inflammation;
• Group II — normal result, with inflammation or degenerative changes, visible regenerative cells;
• Group III — abnormal result, visible cells showing signs of dysplasia (possible inflammation or dysplasia);
• Group IV — cells from pre-invasive squamous cell carcinoma found in the smear;
• Group V — finding squamous cell carcinoma cells or other malignant neoplasm of the cervix.

Regardless of the results, they should be discussed with your doctor. Searching for information on your own can unnecessarily arouse unpleasant emotions and stress. In the event of an incorrect result, the doctor will order further diagnostics.

How long do I have to wait for my Pap smear result?

The Pap smear result is usually ready 3-4 days after performing it. In some settings, where a laboratory test is not performed in-house, it may take longer to receive the result. It usually takes 2-3 weeks.