The Papanicolau test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in gynecology to detect premalignant and malignant (cancerous) processes in the ectocervix. Significant changes can be treated, thus preventing cervical cancer.
The test was invented by and named after the prominent Greek doctor Georgios Papanikolaou. An anal Pap smear is an adaptation of the procedure to screen and detect anal cancers.
In taking a Pap smear, a tool is used to gather cells from the outer opening of the cervix (Latin for "neck") of the uterus and the endocervix.
The cells are examined under a microscope to look for abnormalities.
The test aims to detect potentially pre-cancerous changes (called cervical intraepithelial neoplasia (CIN) or cervical dysplasia), which are usually caused by sexually transmitted human papillomaviruses (HPVs).
The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. The test may also detect infections and abnormalities in the endocervix and endometrium.
In general, it is recommended that females who have had sex seek regular Pap smear testing.
Guidelines on frequency vary, from annually to every three years.
If results are abnormal, and depending on the nature of the abnormality, the test may need to be repeated in six to twelve months.
If the abnormality requires closer scrutiny, the patient may be referred for detailed inspection of the cervix by colposcopy.
The patient may also be referred for HPV DNA testing, which can serve as an adjunct to Pap testing.
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