In the 1940’s, Dr. Papanicolaou developed a technique for sampling the cells of the cervix (Pap smear) to screen patients for cancer of the cervix.

This technique has proven to be very effective at not only detecting cancer, but the pre-cancerous, reversible changes that lead to cancer.

While not originally designed to detect anything other than cancer, the Pap smear has proven useful in identifying other, unsuspected problems. Generally, the Pap smear detects about:

• 90% of cervical cancers,
• 50% of uterine cancers. and
• 10% of ovarian cancers

So useful has the Pap smear become, it is considered an essential part of women’s health care.

Because the Pap smear is a screening test, it can have both false positive and false negative results. For this reason, it is important to have the test performed regularly, but not too often.

A number of forms of Pap smears have evolved. The traditional Pap technique involved smearing the specimen onto a glass slide, which is then processed and read by a cytotechnologist. Newer techniques involve changes in specimen handling (fluid medium) and computer-assisted screening, all designed to improve accuracy.

Interpretation of Pap Smear Results

Results are not always just ‘normal’ or ‘abnormal’. They are often much more nuanced. For help in understanding some of these nuances, look here.

Frequency of Pap Smears

In the past, most experts recommended annual screening with Pap smears for adult women. Based on the experience gained in annual screening, some newer recommendations have evolved, to improve the economic and medical efficiency of Pap smear screening.

For the Typical Patient

• Begin Pap screening at age 21, and repeat the smear every 3 years.
• Discontinue Pap screening after age 65 for low-risk patients, who have had previous normal Pap smears.
• Discontinue Pap screening after a hysterectomy that included the cervix, so long as the hysterectomy was not performed for cervical neoplastic disease.

For the high risk Patient

• Annual screening for immunocompromised women, those with an HIV history, and prior significant cervical neoplasia.