Pap Smear (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Pap smear facts
- What is a Pap smear procedure?
- Who should have a Pap smear?
- What are the risks of having a Pap smear?
- What kind of doctor performs a Pap test?
- How is a Pap smear done?
- How will I find out the results of my Pap smear?
- What is an abnormal Pap smear?
- How is a Pap smear read (analyzed)?
- What information is included on a Pap smear report?
- Why is a woman's menstrual status important for the Pap smear?
- What are risk factors for cervical cancer and precancer?
- Why is a woman's past Pap smear history pertinent?
- When might a Pap smear not be adequate for interpretation?
- How is the final Pap smear diagnosis made?
- What are the possible recommendations for follow-up after a Pap smear?
- What treatments are available if a Pap smear is abnormal?
- What is the current status of human papilloma virus (HPV) testing?
- With Pap smears so available, why are women still dying of cervical cancer?
- Find a local Obstetrician-Gynecologist in your town
What information is included on a Pap smear report?
The first items on a Pap smear report are for purposes of identification. The report is expected to have the name of the woman, the name of the pathologist and/or the cytotechnologist who read the smear, the source of the specimen (in this case, the cervix), and the date of the last menstrual period of the woman.
The Pap smear report should also include the following:
- A description of the woman's menstrual status (for example, "menopausal" (no longer menstruating) or "regular menstrual periods")
- The woman's relevant medical history (example, "history of genital warts")
- The number of slides (either one or two, depending on the health care professional's routine practice)
- A description of the specimen adequacy (whether the sample is satisfactory for interpretation)
- The final diagnosis (for example, "within normal limits")
- The recommendation for follow-up (for example, "recommend routine follow-up" or "recommend repeat smear")
Why is a woman's menstrual status important for the Pap smear?
A woman who is menstruating sheds cells from the lining of her uterus called endometrial cells. If these cells are seen on the Pap smear of a menstruating woman, the report may note that these cells are present. This is normal if the Pap test was done around the time of the woman's menstrual period. The comment that these cells are "cytologically benign" means that they do not appear to be malignant (cancerous) cells.
However, if a woman is menopausal (no longer menstruating) she would not be expected to be shedding cells from the uterine lining. Therefore, endometrial cells on a Pap report might be indicative of an abnormal thickening of the endometrium, the lining of the uterus. The Pap smear is not specifically designed to detect such an abnormality. Nonetheless, if these cells are noted in a non-menstruating woman, her doctor should attempt to determine the cause of the shedding of the endometrial cells.
Sometimes, the cause is endometrial hyperplasia, a precancerous condition of the uterine lining, which can be detected by a relatively simple office procedure called an endometrial biopsy. Sometimes, menopausal hormone therapy can cause shedding of endometrial cells that appear on a Pap smear. The pattern of bleeding, the exact type of hormone therapy, and the individual woman's health history are the three components that guide the physician to know whether and what type of further evaluation is necessary.
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