A Pap smear is a screening test to check if abnormal changes have occurred in cells of the cervix. A Pap smear is also called a cervical smear.
A layer of cells called squamous cells covers the outside surface of the cervix. A layer of cells called glandular cells lines the endocervical canal. These two types of cells meet at the ‘transformation zone’, which is usually on the outside of the cervix but may be just inside the endocervical canal.
When taking a Pap smear, the doctor generally scrapes cells from these areas. The examination will determine whether the cells are normal or abnormal.
Treatment to remove abnormal cells on the cervix in most cases:
Without treatment, the risk is that the abnormal cells may develop into cervical cancer. Regular Pap smears are important because the growth of precancerous cells on the surface of the cervix does not usually cause pain or other physical symptoms. A Pap smear is the only means of detecting precancerous cells.
Colposcopy is a visual examination of the cervix to check for precancerous changes. The procedure is usually undertaken in a doctor’s room.
The doctor uses a colposcope (a magnifying instrument similar to a pair of binoculars with a light attached) to examine the cervix. The colposcope is not put inside the vagina, only the speculum.
The cervix is painted with weak acetic acid (vinegar), which causes abnormal cells to turn white; both iodine and acetic acid may be used. The resulting pattern can help your doctor to decide if this is a high-grade or low-grade lesion.
Your doctor may remove a small sample of tissue (biopsy) from any abnormal looking area. A special solution may be applied to the biopsy area to stop any bleeding. If a biopsy has been taken, you may have some pain or discomfort similar to menstrual cramping, which can be treated with a pain reliever. Avoid sex, tampons or baths (shower instead) for a week to allow the cervix to heal.
If the results of colposcopy and biopsy indicate a high-grade abnormality (CIN-2 or CIN-3), your doctor will recommend treatment to remove the abnormal cells. Treatment may also be recommended for persistent low-grade abnormalities.
Several methods of treatment are effective. The best treatment for you will depend on the type and severity of the abnormal cells.
Some doctors prefer one treatment method to another. You may wish to discuss this with your doctor.