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The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), [1] cervical smear (BE), cervical screening (BE), [2] or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix (opening of the uterus or womb) or, more rarely, anus (in both men and women). [3]
Because of this, LSIL results can be managed with a simple "watch and wait" philosophy. However, because there is a 12–16% chance of progression to more severe dysplasia, the physician may want to follow the results more aggressively by performing a colposcopy with biopsy. [7] If the dysplasia progresses, treatment may be necessary.
The most common investigation in this field is the Pap test, which is used to screen for potentially precancerous lesions of the cervix. Cytology can also be used to investigate disorders of the ovaries, uterus, vagina and vulva. Gynaecologic cytology makes frequent use of the Bethesda system in order to grade the results of HPV testing. [2]
However, it is acceptable to screen this age group with a Pap smear alone every 3 years or with an FDA-approved primary high risk HPV test every 5 years. [11] In women over the age of 65, screening for cervical cancer may be discontinued in the absence of abnormal screening results within the prior 10 years and no history of high-grade lesions ...
Women aged 30–65 should preferably be tested every 5 years with both the HPV test and the Pap test. In other age groups, a Pap test alone can suffice unless they have been diagnosed with atypical squamous cells of undetermined significance (ASC-US). [133] Co-testing with a Pap test and HPV test is recommended because it decreases the rate of ...
The two screening methods available are the Pap smear and testing for HPV. CIN is usually discovered by a screening test, the Pap smear. The purpose of this test is to detect potentially precancerous changes through random sampling of the transformation zone. Pap smear results may be reported using the Bethesda system (see above).
HPV disease is the leading cause of cervical cancer, therefore making the HPV vaccine the primary prevention measure for the cancer. Screening with the Papanicolaou (Pap) test is consequently the second measure of prevention. [27] The test identifies cells that are precancerous, and are often credited for the reduced mortality. [28]
The Pap test can be used as a screening test but produces a false negative in up to 50% of cases of cervical cancer. [ 58 ] [ 59 ] Another concern is the cost of doing Pap tests, which makes them unaffordable in many areas of the world.