Cervical cancer is one of the most common causes of cancer worldwide. It also remains one of the most preventable and treatable cancers. One of the screening tests which can be done to detect the presence of Cervical Cancer is the "Pap Smear Test".

The Pap smear procedure is named after Dr. George Papanicolaou. He unexpectedly discovered that women with uterine cancer had "abnormal cells, with enlarged, deformed, or hyper chromatic nuclei."  He called the discovery of these abnormal cells on the smear as "One of the most thrilling experiences in my scientific career."  It is as the creator of the “Pap” smear that Dr. Pap is best remembered today due to his work!During the Pap smear test, a sample of cells from a woman's cervix is collected and spread on a microscope slide. The cells are examined under a microscope in order to look for pre-malignant or malignant changes.

Procedure For Testing Cervical Cancer 

Pap Smear, also called as “Pap Test” in short  can be defined as a screening medical procedure done to trace the presence of cancer cells in the cervix of women. A Pap smear is a simple, quick, and relatively painless screening test.

Here are some issues for a doctor to be consulted for getting examined for Cervical Cancer:

1. A woman should have a Pap smear test done when she is not menstruating. The best time for screening is between 10 and 20 days after the first day of her menstrual period.
2.  For about 2 days before testing, a woman should avoid douching or using spermicidal foams, creams, or jellies or vaginal medicines, as these agents may wash away or hide any abnormal cervical cells.
3. The physician prescribed medicines can be used with the permission.
4.  Pregnancy does not prevent a woman from having a Pap smear. Pap smears can be safely done during pregnancy.
5.  Pap smear testing is not indicated for women who have hysterectomy, with removal of the cervix.
6.  Women who have had a hysterectomy in which the cervix is not removed, called subtotal hysterectomy, should continue screening following the same guidelines as women who have not had a hysterectomy.
7.  Pap smears are recommended for all women starting at age 21 years or within 3 years of becoming sexually active, whichever comes first.
8.  Most women over age 30 who have had reliable Pap screening with persistently normal results can be screened less often than yearly.

Here is a detailed explination how a result for the Pap test looks like:

The Pap smear is analyzed according to a uniform standardized system. A recording of the woman's menstruation status and whether and when she had abnormal Pap smears previously, is essential to the reader of the current Pap smear. The results of the Pap smear are usually available in 2 to 3 weeks. At the end of Pap smear testing, each woman should ask how she should expect to be informed about the results of her Pap smear. If a woman has not learned of her results after a month, she should contact her clinician's office. New guidelines recommend that most women over 65-70 years old who have had regular Pap screening with negative results can stop having Pap tests, because abnormal Pap smears are very unusual in this setting.  

Liability Of Pap Test

Its ability to avoid classifying a normal smear as abnormal is very good.  The sensitivity of a Pap smear test, which means its ability to detect every single abnormality, is extremely good. But, in spite of its efficiency, a few women develop cervical cancer despite having regular Pap screening. In the vast majority of cases, a Pap test does identify minor cellular abnormalities before they have had a chance to become malignant and at a point when the condition is most easily treatable. The Pap smear is not intended to detect other forms of cancer such as those of the ovary, vagina, or uterus. Cancer of these organs may be discovered during the course of the gynecologic (pelvic) exam, which usually is done at the same time as the Pap smear.

Causes for Abnormal Pap Smear Results:

1. The genital wart virus, also called the human papilloma virus (HPV), is the major cause of abnormal Pap smear results, although most women with HPV infection do not get cervical cancer. (See below for details). About 95-100% of cervical cancers have signs of HPV infection on sophisticated testing. Most HPV infections in young women are transient, whereas in older women, HPV infections are less common and more likely to be persistent.
2. Some women are more likely to have abnormal Pap smears than other women. One common cause of abnormal Pap smears is smoking. Although smoking is associated with many different cancers, many women do not realize that smoking is strongly linked to cervical cancer. Smoking increased the risk of cervical cancer about 2- to 4-fold.
3. Other less significant risk factors for abnormal Pap testing include having multiple sexual partners and becoming sexually active at a young age.

It is critically important to recognize that the women who are at highest risk for abnormal Pap smear testing are those who are NOT getting regular Pap testing done. Therefore, it follows that in order to improve overall Pap smear screening, women who are not getting regular Pap smears should be educated about and offered Pap testing. Most of the Pap Smear unscreened women are more likely to get this with invasive cervical cancer. Women who have not had Pap smear screening tend to be concentrated in certain population groups including:

1. Older women.
2. The uninsured.
3. Women in Ethnic minorities.
4. Poor women.
5. Women in rural areas.
6.  Women who are not educated about Pap Smear test.

These under-served women should be the most heavily targeted for Pap screening.The emphasis of this screening should be on universal access. As the proper, Pap screening is opposed to be a small benefit that would come from utilizing the newer technologies.  All the women should be educated about the importance of the test and thus wash out Cancer and many other related problems of women.

1. The test for cervical cancer is Pap Smear test.
2. A Pap smear can be done in a doctor's office, a clinic, or a hospital by either a physician or other specially trained health care professional, such as a physician assistant, a nurse practitioner, or a nurse midwife.
3. With the woman positioned on her back, the clinician will often first examine the outside of the patient's genital and rectal areas, including the urethra (the opening where urine leaves the body), to assure that they look normal.
4. A speculum is then inserted into the vaginal area. The speculum is an instrument that allows the vagina and the cervix to be viewed and examined. A cotton swab is sometimes used to clear away mucus that might interfere with an optimal sample.
5. A small brush called a cervical brush is then inserted into the opening of the cervical os and twirled around to collect a sample of cells.
6. This sample is called the “Endocervical sample”, as it comes from inside the cervix.
7. A second sample is also collected as part of the Pap smear and is called the “Ectocervical sample”, as it is collected from outside the Cervix, a scraping of the area surrounding, but not entering, the cervical os.
8. Both the endocervical and the ectocervical samples are gently smeared on a glass slide and a fixative is used to prepare the cells on the slide for laboratory evaluation.
9. These cells are examined under a microscope in order to look for pre-malignant or malignant changes.
10.  Inspite of the Pap Smear test, there is another special examination done by the doctor. This is a bimanual examination. This usually follows the collection of the two samples for the Pap smear. The bimanual examination involves the examiner inserting two fingers of one hand inside the vaginal canal while feeling the ovaries and uterus with the other hand on top of the abdomen (belly).
11.  Note:  There are absolutely no known medical risks associated with Pap smear screening.