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What is a pap smear?

There are two words in the English language guaranteed to make most women grimace: Pap test. This is an important diagnostic test, but one that many women think of negatively. Dr. Michael Liao of UVA Obstetrics & Gynecology wants his patients to understand what a Pap test is, why it is important and how to make the exam less unpleasant.

“In 1943, Dr. Papanicolaou published a paper highlighting the benefit of the examination of cervical secretions as a screening tool for cervical cancer,” Dr. Liao explained. “Back then, secretions were collected from the cervix during a pelvic exam, and then smeared on a slide to be examined under a microscope.”

Now, improved technology means collected specimen are instead placed in a liquid solution and processed mechanically instead of being examined on a slide. Still, the name Pap smear remains common, while some have started referring to it as a Pap test.

“Pap tests can help us identify not only cervical cancer, but the presence of human papillomavirus, or HPV,” Dr. Liao said. “HPV can be a causative agent for cervical cancer in some cases. In other cases, the body can clear this virus on its own.”

In the past, women over age 18 were told to get a Pap smear every year. “Now, though, we recommend Pap tests starting at age 21,” Dr. Liao explained. “In a woman with normal Pap test results and few risk factors, testing is only needed once every three years.”

But Dr. Liao says even though a Pap test does not have to be done annually, it is still very important. “The Pap test has saved many lives by detecting cervical cancer early,” Dr. Liao said. “Given that it’s such an easy test and it’s so effective, there’s no good reason to avoid it.”

And to those patients who are afraid the test will hurt? “The best thing you can do to make a Pap test more comfortable is to relax,” Dr. Liao advised. “If you breathe and keep your muscles from tensing, the test should not hurt.”



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