Pap smears are read by cytotechnologists and pathologists.
Cytechnologits are specially trained to identify cell abnormalities. They systematically inspect the entire Pap smear for abnormal cells.
Any abnormality is marked for further evaluation by a pathologist who confirms the type of abnormality present.
After your Pap smear has been carefully examined, the results are reported to and may be discussed with your physician, who should discuss them with you.
Cytotechnologists must be graduated from an accredited school of cytotechnology and successfully pass a certification examination given by a certifying organization, such as the American Society of Clinical Pathologists (ASCP) Board of Registry.
Pathologists are physicians who, after medical school, complete a four to five year residency in pathology and are specially trained to make diagnoses by examining tissues or cells.
What Do the Results Mean?
A "normal" smear means there are no detectable abnormalities or problems. An "abnormal" result means you and your physician must discuss some follow-up treatment.
Some abnormal results are:
1) the effects of microorganisms or viruses (possibly sexually transmitted diseases) may be seen on the smear.
2) the cells may be changed in reaction to an infection or a similar type of injury. These reactive changes are temporary and benign - they do not indicate cancer.
3) the cervical cells may exhibit changes that could be identified as precancerous conditions.
The recommended follow-up would probably be another Pap smear in three to six months or a colposcopy. This is examination of the cervix using an instrument with magnifying lenses.
A biopsy of tissue may be taken for additional examination, and the area may be treated with electrocoagulation, laser or cryosurgery to destroy the problem tissues.
Sometimes it is not immediately possible to tell if suspicious-looking cells are a benign change (not fatal) or a premalignant change (recurring or possibly fatal).
However, an abnormal Pap smear result alerts your physician that a medical problem may exist and that further evaluation is needed.
Less often, Pap smears show malignant cells. The recommended follow-up may include colposcopy, several forms of biopsy, or more complicated surgery. Follow-up on all abnormal findings and compliance with expert advice are critical.
Can I Trust the Results of my Pap Smear?
Like any medical test, the Pap smear is not infallible. It can fail to detect an abnormality, which is known as a "false negative." It can also result in a "false positive," in which cells are thought to be precancerous or cancerous, but are not.
Each step of preparing and processing the Pap smear is critical. The best results are obtained when all steps in the process, from removing the cervical cells to interpreting the smear and reporting the results, are performed by highly qualified professionals.
Yet, even with the most qualified and experienced gynecologists or other health care providers, cytotechnologists and pathologists, there is the possibility of error.
This may result from too few abnormal cells in the sample from a tiny or hard-to-reach lesion, inadequate sampling of cells from the cervix, improperly preparing the smear, failure to detect abnormal cells during screening, or interpretive error.
This is why the ASCP urges an annual Pap smear for all women who are or have been sexually active or who are 18 or older. Cervical cancer develops slowly, and a yearly Pap smear will allow multiple opportunities to detect an abnormality while it is easily treatable. The sooner cancerous or precancerous cervical conditions are detected, the greater the likelihood of a cure.
How To Assure the Most
Accurate Pap Smear Result
1.Schedule your gynecologic exam at the optimum time - two weeks after the first day of your last menstrual period. Do not schedule it during your menstrual period.
2.Do not use vaginal medications, creams, contraceptives, or douches for 72 hours prior to the exam.
3.Abstain from intercourse for 24 hours before the exam.
4.Make sure your Pap smear is sent to an accredited laboratory that employs nationally certified cytotechnologists and board certified pathologists.
5.Call your doctor to get your test results and schedule any follow-up necessary.
From American Society of Clinical Pathologists
