Thursday, March 22, 2012

"PAP" Series part 3: What the PAP?

***In order to keep this series light-hearted and easy to read I am not going to quote or site any sources except the knowledge of what I have learned through conferences, school, from pathologists and others who have gone on before me. THIS IS NOT TO REPLACE ANYTHING YOUR DOCTOR/NURSE PRACTITIONER/MIDWIFE/PA etc IS TELLING YOU. This is just some easy to read information***

ps- there is a diagram of a cervix on this page- just a warning. I found the image HERE

So what exactly is a pap smear? and why is it called that?? I really have no idea why it is called that- and I don't want to look on Wikipedia for the answer- so let's just say some it is named after some man named Dr Pap Smear (ugh- I couldn't help myself- I looked on wikipedia and the guy's name is Georgios Papanikolaou.)

A pap is a collection of a small sample of cells about 5 million cells- eh- no biggie) on your cervix (the entrance to your uterus). It is called a "smear" because we used to take those cells, smear them onto a slide, and look at them under a microscope (like 15 years ago). Now we just take the sample of cells- deposit them into a container of liquid and send it off to the lab for them to evaluate. So that is the reason why it kind of pinches when it happens... We are scraping off cells from a very sensitive area of your body. This is also why you might have a little spotting or cramping after your exam.
Bleeding after your pap smear doesn't mean your cells are abnormal or not... it doesn't mean you have an infection... it just means your cervix sometimes bleeds with a pap smear. About 50% of the pap smears I do a day have a little bleeding.

Anyway, a pap smear is a screening test for cervical cancer. SCREENING. It does not show if you have cancer of your cervix.

Then why get a pap smear? Well, a pap smear gives us an indication on which women need to have further evaluations or a DIAGNOSTIC procedure. To diagnose if there is cervical cancer or even any precancer cells.

other couple other examples of this:
-glucose test in pregnancy- if this screening test is elevated you do a 3 hour test as a diagnostic procedure to see if you actually have diabetes in pregnancy.
-Mammogram- if you have abnormal breast tissue you do a diagnostic breast biopsy in order to see if you actually have breast cancer
-AFP testing in pregnancy- a screening test to find out if there is a risk of your baby having downs, spina bifida, etc. The diagnostic test is an amniocentesis.

Like any of these tests there are false negatives and false positives. The pap smear could indicate you have abnormal cells, and then we do a diagnostic test and you don't have any. It could also show that there are no abnormal cells, when in all reality you may have them. However, this is the best we have currently. Since there are really no signs on cervical cancer- no pain, weird bleeding (unless far progressed) it is important to have your pap smears done.

Stay tuned for the current guidelines of when and how often to get your pap smear done.

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