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 are risk factors for cervical cancer and precancer?
A number of risk factors have been identified for the development of cervical cancer and precancerous changes in the cervix.
- HPV: The principal risk factor is infection with the genital wart virus, also called the human papillomavirus (HPV), although most women with HPV infection do not get cervical cancer. Almost all cervical cancers are related to HPV infection. Some women are more likely to have abnormal Pap smears than other women.
- Smoking: One common risk factor for premalignant and malignant changes in the cervix is smoking. Although smoking is associated with many different cancers, many women do not realize that smoking is strongly linked to cervical cancer. Smoking increases the risk of cervical cancer about two to four fold.
- Weakened immune system: Women whose immune systems are weakened or have become weakened by medications (for example, those taken after an organ transplant) also have a higher risk of precancerous changes in the cervix.
- Medications: Women whose mothers took the drug diethylstilbestrol (DES) during pregnancy also are at increased risk.
- Other risk factors: Other risk factors for precancerous changes in the cervix, having an abnormal Pap test, having multiple sexual partners, and becoming sexually active at a young age.
Why is a woman's past Pap smear history pertinent?
If a woman has had a history of a cellular abnormality on a previous Pap smear, it is important for her to inform the health-care professional performing the current Pap smear. The woman should provide the details of any previous problems and treatments so that this information can be noted on the lab form. The past history of the woman helps the person who is reading (interpreting) the current Pap smear, because a particular abnormality on previous screening alerts the health-care professional to look more carefully for specific findings on the current Pap smear.
When might a Pap smear not be adequate for interpretation?
It is a requirement that the report comment on the adequacy of the smear sample for Pap analysis. If the sample is inadequate, the report details the reason. Examples of problems that might be listed under "sample adequacy" include "drying artifact" or "excessive blood." These comments refer to factors that the person analyzing the smear feels may have interfered with his or her ability to interpret the sample.
Sometimes, a Pap smear report will read "unsatisfactory due to excessive inflammation." Inflammation that is present in the woman's cervical area may make it difficult to interpret the Pap smear. Examples of causes of inflammation might include infections or irritation. Inflammation is a common finding on pap smears. If it is severe, your doctor may want to try to determine the cause of the inflammation. In many cases, a repeat pap smear is recommended to determine if the inflammation has resolved and to obtain a sample that is adequate for interpretation.
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