The Pap test, also known as a pap smear, identifies abnormal changes in the cells of the cervix. This study has several applications in practice, including: Screening. Pap smears are most often used to screen for cervical cancer in people without symptoms. It is able to identify cervical cancer at an early stage, as well as changes in the cells of the cervix that can become cancerous if left untreated. When used as a screening test, the Pap smear can be used alone or in conjunction with a test for strains of human papillomavirus that can cause cervical cancer. Diagnosis. A Pap smear can be used to determine the underlying cause of vaginal symptoms, including unusual vaginal bleeding or the presence of a vaginal discharge. Monitoring. The Pap smear may be used as a follow-up test to monitor cervical cell abnormalities or other findings found on the initial pap smear. The procedure involves taking a sample of cells from the opening of the cervix and examining them under a microscope for signs of abnormalities. Pap smear results indicate whether the cervical cells appear normal, abnormal, or the test result is unclear. Abnormal smear results are described according to the type of abnormality found, as well as the type of cell in which the abnormality is found. Cervical cancer screening is recommended for women between the ages of 21 and 65. Experts recommend that women between the ages of 21 and 29 be screened with a pap smear every three years. For women between the ages of 30 and 65, it is recommended that the examination be carried out annually. Before a Pap smear, it is important to note all medications the patient is taking and any abnormal results from previous tests. The procedure is not performed during menstruation, it is recommended that it be done between the third and fifth day after the last period. Additional pre-test precautions include avoiding the following activities for two to three days before a Pap smear: Using tampons Having sex Using vaginal creams or contraceptive foams Pap smear results are reported as normal, abnormal, or unsatisfactory for evaluation. A normal, also called negative, Pap smear result indicates that no evidence of abnormal cells was found in the sample. Cell types commonly described in Pap smear results include squamous and glandular cells. Abnormal changes in squamous cells are divided into several categories: Atypical squamous cells. They are the most common abnormal finding on Pap smear. Atypical squamous cells may be reported as atypical squamous cells of undetermined significance or atypical squamous cells that cannot exclude a high-grade squamous intraepithelial lesion. Both results showthat cervical cells appear abnormal under the microscope, but the significance of the cellular changes is unclear. Low-grade squamous intraepithelial lesions. Sometimes called mild dysplasia, this result indicates that the smear detected mild cellular changes. The result does not necessarily require treatment, as these changes are often resolved by the immune system, especially in younger women. High-grade squamous intraepithelial lesions. Sometimes called moderate or severe dysplasia, this finding indicates that many abnormal cell changes have been found. These changes are more likely to progress to cancer if left untreated. Carcinoma in situ (CIS). This result indicates that more serious cellular changes were detected during the smear. These changes look similar to cervical cancer, but have not yet spread beyond the surface of the cervix. CIS is likely to progress to cancer if left untreated. Squamous cell carcinoma. Squamous cell carcinoma is a type of cervical cancer. Finding squamous cell carcinoma in a Pap smear is very rare for patients who receive regular screening for cervical cancer. This result indicates that the abnormal squamous cells have spread deeper into the cervix or other parts of the body. References: ADAM Medical Encyclopedia. Pap test. Updated January 1, 2020. Accessed April 21, 2021.