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Definition
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A
Pap smear involves collecting cells from your cervix — the lower, narrow end of your
uterus.
Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure,
should cervical cancer be detected. A Pap smear can also detect changes in your cervical
cells that suggest cancer may develop in the future. Detecting these cells early with a Pap
smear is your first step in halting the possible development of cervical cancer.
After age 21, the groups' guidelines differ slightly because each takes different factors
into consideration. Here's a look at Pap smear guidelines from the American Cancer
Society (ACS), the American College of Obstetricians and Gynecologists (ACOG) and
the U.S. Preventive Services Task Force (USPSTF):
If you have certain risk factors you should undergo a Pap smear annually, regardless of
your age. These risk factors include:
Risks
A Pap smear is a safe way to screen for cervical cancer. However, a Pap smear isn't
foolproof. It's possible to receive false-negative results — meaning that the test indicates
no abnormality, even though you do have abnormal cells.
Estimates for the occurrence of false-negative results with a conventional Pap smear vary
widely but are at least 5 percent — or one in every 20 women. The liquid-based Pap test,
in which the sample of cells is preserved in liquid rather than smeared on a microscope
slide, provides fewer false-negative results. With either test, false-positive results —
when the test indicates an abnormality when there really isn't one — are extremely rare.
A false-negative result doesn't mean that a mistake was made. Many factors can cause a
false-negative result, including:
Although it's possible for abnormal cells to go undetected, time is on your side. Cervical
cancer takes several years to develop. And if one test doesn't detect the abnormal cells,
the next test most likely will.
You'll lie down on your back on an exam table with your knees bent. Your heels rest in
supports called stirrups.
Your doctor will gently insert an instrument called a speculum into your vagina. The
speculum holds the walls of the vagina apart so that your doctor can easily see your
cervix. Inserting the speculum may cause sensation of pressure in your pelvic area.
Sometimes the speculum feels cold when it's first inserted.
Then your doctor will take samples of your cervical cells using a soft brush and a flat
scraping device called a spatula. This doesn't hurt and you may not even feel the sample
being taken.
Depending on the type of Pap test you're undergoing, your doctor transfers the cell
sample collected from your cervix onto a glass slide or into a container holding a special
liquid to preserve the sample (liquid-based Pap test).
Ask your doctor about when you can expect the results of your Pap smear. In some cases,
your doctor will only contact you if something of concern is found or if it's determined
that you need further testing.
The narrow neck of the uterus is called the cervix. This is where cervical cancer may
develop.
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Pap smear
Pap smear
During a pelvic exam, your doctor uses a speculum to hold your vaginal walls apart. If
your pelvic exam also includes a Pap test, your doctor collects a sample of cells from
your cervix, using a small cone-shaped brush and a small plastic spatula (1 and 2). Your
doctor then transfers the cells onto a glass slide (3) for examination under a microscope.
Or your doctor may rinse the brush in a liquid-filled vial (4) and send the vial to a
laboratory for testing.
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Results
The Pap smear can alert your doctor of suspicious cells that need further testing.
Normal results
If only normal cervical cells were discovered during your Pap smear, you're said to have
a negative result. You won't need any further treatment or testing until you're due for
your next Pap smear and pelvic exam.
Abnormal results
If abnormal or unusual cells were discovered during your Pap smear, you're said to have
a positive result. A positive result doesn't mean you have cervical cancer. What a positive
result means depends on the type of cells discovered in your Pap smear.
Here are some terms your doctor might use and what your next course of action might be:
If your Pap smear is abnormal, your doctor may perform a procedure called colposcopy
using a special magnifying instrument (colposcope) to examine the tissues of the cervix,
vagina and vulva. He or she may take a tissue sample (biopsy) from any areas that appear
abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive
diagnosis.
Depression is treated with counseling and medications. Although treating depression can
help with erectile dysfunction, some antidepressants have sexual side effects. If you do
have bothersome sexual side effects, you may need to try another antidepressant. Your
doctor can also decrease the dose or add another medication to offset the effects of the
antidepressant on erectile dysfunction.
The same factors that raise your risk of atherosclerosis in the arteries in your penis also
increase your chances of heart disease. Because the arteries supplying your penis are
smaller than the ones to your heart, symptoms may first show up as erectile dysfunction.
If you haven't been diagnosed with heart problems, consider erectile dysfunction a wake-
up call. It could be a warning sign that the blood vessels feeding your heart might also be
in trouble.
Although you can't stop taking your medications, there may be other drug options that are
less likely to cause erectile dysfunction. Discuss your symptoms and potential options
with your doctor.
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