Many women go to their physician yearly for their annual exam but may be unclear exactly what is getting tested or screened during their exam. Most annual exams include a pap smear. A pap smear is a scraping of the cervix (the lowermost portion of the uterus). The pap smear is screening for cervical cancer. A pathologist looks at the cells obtained from the scraping of the cervix and determines if the cells look normal, look atypical or look dysplastic. Atypical cells are abnormal but not necessarily considered pre-cancerous. Dysplastic cells are considered pre-cancerous lesions. A pap test does not screen for uterine or ovarian cancer. Unfortunately, there are not any screening tests currently available for these types of cancers. A physician usually feels the uterus and ovaries during the annual exam to see if there are any masses that would be concerning for cancer.
Current recommendations for pap smear screening are beginning screening at the age of 21, screening every 2 years between the age of 21 and 30, and every 3 years after the age of 30 if the patient's last 3 pap tests have been negative. A patient may need more frequent testing if she has a history of HIV, or immunocomprised. If the pap smear shows atypical cells, a test for the presence of the human papilloma virus will be performed. The human papilloma virus is the main cause of cervical cancer. If the virus is present, further testing for cancerous cells will need to be performed which is called a colposcopy. This test involves looking closely at the cervix with a microscope during a pelvic exam. If abnormal cells appear under the microscope, a biopsy of the cells will be taken to evaluate for pre-cancerous or cancerous lesions. If the pap smear shows dysplastic cells, a colposcopy is needed as well.
Please look at the following link for more detailed information:
http://www.acog.org/Resources_And_Publications/Practice_Bulletins/Committee_on_Practice_Bulletins_--_Gynecology/Cervical_Cytology_Screening
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