Pap tests are done on women who have no symptoms of cancer and have no findings suggesting a cancer. Thus, Pap tests are done only on women who are normal. If the woman has symptoms or findings suggestive of cancer of the cervix then a diagnostic test must be done to exclude a cancer or to diagnose a cancer. Diagnostic tests are usually biopsies. This is the single most important lesson to learn: if you have a symptom or a finding that could be due to a cancer of the cervix, a normal Pap test never excludes the possibility of cancer. In the vast majority of instances, an abnormal Pap test results in the diagnosis of a minor change on the cervix. Some of these changes will be premalignant, but most will be of minor significance. They will all have to be evaluated, diagnosed and treated, but most will be easily and effectively treated. Occasionally, a real cancer will be present which is why this is such an important test. Most cancers are visible on examination and can be biopsied as soon as they are seen. Sometimes the cancers are inside the cervix beyond view and the only indication that it is there is the abnormal Pap test.
Many women do not obtain annual Pap tests. Many who do think that a normal Pap test means that they are cancer free. The Pap test evaluates only the squamous epithelium covering the visible part of the cervix. The endocervical canal has a glandular epithelium that is not easily evaluated by Pap tests. This glandular epithelium can also become malignant and not be detected. Cancers of the uterus, ovaries and fallopian tubes are not usually detected by the Pap test.
Pap test screening is recommended for all women beginning at age 18 years or at the onset of sexual activity, if earlier. The screening interval is usually every year, although, if there have been no previous abnormal tests, the interval may be extended. Gently scraping cells from the cervix, smearing them onto a microscope slide and sending it to a pathology laboratory for evaluation perform the Pap test. There are two reporting systems in current use. The newer Bethesda System is replacing the older system, which reported the result in one of five classes.
Source: William M. Rich, M.D.
Clinical Professor of Obstetrics and Gynecology
University of California, San Francisco
Cervical Dysplasia - Pap Test Informative Links
All About Pap Tests
Explains the screening test for malignant and premalignant changes of the cervix.
BBC Health: Cervical Smear Test
General information on the procedure, as well as advice.
National Women's Health Information Center: Pap Smear
Answers to frequently asked questions.
Pap Smear Email Reminder
From the College of American Pathologists.
Pap Test: Cervical Changes and Health Care
Explains the classifications of squamous and glandular cells.
Cervical Dysplasia - Informative Links
Cervical Dysplasia Clinical Trials
Clinical Trials available for Cervical Dysplasia. Georgia. Southeast Research Associates (SERA).
Cervical Dysplasia
All About Cervical Dysplasia including numerous graphics.
BestHealth - Wake Forest University Baptist Medical Center - Cervical Dysplasia
What is cervical dysplasia? How does it occur? What are the symptoms? How is it diagnosed? What is the treatment? How can I take care of myself?
Discovery Health - Disease and Conditions -- Cervical Dysplasia
Cervical dysplasia By Eva Martin, MD.
GMHC: Fact Sheet -- Cervical Dysplasia
What is cervical dysplasia?
Johns Hopkins Cervical Dysplasia
Infation from the Johns Hopkins Center for Cervical Dysplasia.
Cervical Dysplasia - More Studies and Information
Over the past 10 years Dr. Joe Glickman, Jr. has assembled a great deal of research from the medical literature. Dr. Glickman has published medical text books for over 20 years. The website, www.health-science-report.com
, published by Dr. Glickman, has been called the single most useful tool to understanding the significance of cervical dysplasia and HPV. Be sure to check out Dr. Glickman's website.
