Pap Test

Overview :

The Pap test is an extremely cost-effective and beneficial exam. Cervical cancer used to be a leading cause of cancer deaths in American women, but widespread use of this diagnostic procedure reduced the death rate from this disease by 74% between 1955 and 1992. A 2003 study reported that the test reduces rates of invasive cervical cancer by as much as 94%. In 2003, the FDA approved a new screening test that combines DNA testing for the HPV type that causes the most cases of cervical cancer with the standard Pap test, increasing its screening value.

The Pap test, sometimes called a cervical smear, is the microscopic examination of cells scraped from both the outer cervix and the cervical canal. (The cervix is the opening between the vagina and the uterus, or womb.) It is called the "Pap" test after its developer, Dr. George N. Papanicolaou. This simple procedure is performed during a gynecologic examination and is usually covered by insurance. For those with coverage, Medicare will pay for one screening Pap smear every three years.

During the pelvic examination, an instrument called a speculum is inserted into the vagina to open it. The doctor then uses a tiny brush, or a cotton-tipped swab and a small spatula to wipe loose cells off the cervix and to scrape them from the inside of the cervix. The cells are transferred or "smeared" onto glass slides, the slides are treated to stabilize the cells, and the slides are sent to a laboratory for microscopic examination. The entire procedure is usually painless and takes five to 10 minutes at most.

The newer method called liquid-based cytology, or the liquid-based Pap test, involves spreading the cells more evenly on a slide after removing them from the sample. The liquid-based method prevents cells from drying out and becoming distorted. Studies show that liquid-based testing slightly improves cancer detection and greatly improves detection of precancers, but it costs more than the traditional Pap test. Trade names in 2003 for liquid-based Pap smears were ThinPrep and AutoCyte.