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Overview. A Pap smear is a safe, non-invasive
procedure done in an exam room by your provider. A small brush
will be used to collect cell samples from the cervix. They
are then sent to a lab where pathologists and other specially
trained individuals examine the sample. The cells are being
examined for changes from what a normal cell looks like. These
changes can be an indicator of the possible development of
cervical cancer. Cervical cancer does not occur overnight;
there is a progression of changes that happen to these cells
before they are cancerous. Having a pap smear frequently allows
your provider to identify these (precancerous) cells early
so that effective (and less invasive) treatment can begin
as soon as possible.
Frequency. Your first Pap smear should be
done within three years of vaginal intyercourse, or by the
age of 21 at the latest. Your provider will discuss the frequency
of subsequent Paps, based on your sexual activity and family
history. In general, Pap smears should be done annually until
your provider has solid evidence that the frequency can be
extended to a longer cycle, perhaps every two or three years.
You should still have your annual exam to evaluate your total
health condition even if your Paps are done on a different
cycle.
Results. A negative Pap smear means that
the results of examining your cervical cells are normal, within
normal limits of variability.
A positive Pap smear means that your results aren’t normal.
There may be a simple inflammation or infection such as a
yeast infection, HPV, or other infections.
Changes in the cells that are very early signs of cancer
are called dysplasia.
Changes in these cells on the surface of the cervix that
are a more serious sign of cancer may be classified as squamous
intraepithelial lesion (SIL). They may be described as low-grade
or high-grade in nature.
Cells that are classified as cervical intraepithelial neoplasia
(CIN) are cancerous. The penetration of the cancerous cells
into the lining of the cervix is measured on a relative scale
for 1 to 3, with 3 representing a deeper penetration of the
abnormal, cancerous cells.
If the results are atypical squamous cells, then the findings
are unclear; they are not necessarily cancerous.
Treatment. Your provider will discuss treatment
options with you. If there is a simple infection that can
be treated medically, that will promptly be done. Your doctor
may perform a colposcopy in the office to more closely examine
the cervix and vagina in detail. The microscope comes equipped
with a light to more clearly display the area. A biopsy (small
sample) of the affected area may be sent to a lab for more
detail review.
Again, depending on the results of these advanced examinations
and samplings, your doctor will discuss additional treatment
options, which include more invasive surgery.
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