wwc   ny

PAP SMEAR   |   HPV   |   COLPOSCOPY

WHAT IS A PAP SMEAR?

The pap test, also called the papanicolaou smear is a test used to screen for cervical cancer. To do a pap smear, a speculum is used to open the vagina. A few cells are taken from the cervix (an opening below the uterus) with a brush or small spatula. These cells are tested in a lab for changes that may lead to cervical cancer and changes that look like cervical cancer.

WHO SHOULD HAVE THE TEST?

  • A pap test is recommended for women at 21 years of age.
  • Women 21-29 years should get a pap test every 3 years.
  • Women 30-65 years should have a pap test and HPV test every 5 years (or a pap test alone every 3 years).
  • Women over 65 who have no history of cervical dysplasia or cervical cancer and have at least 3 negative pap tests in a row or two negative pap and HPV tests can stop having pap tests done.

WHAT DOES AN ABNORMAL PAP TEST MEAN?

  • “Negative” Pap test results mean you have NO abnormal, precancerous or cancerous cells.
  • Abnormal results may require additional testing.
  • If your pap test results are abnormal and you are over 25 years of age, your doctor will likely suggests further evaluation with a colposcopy, which is a way to examine the cervix using a magnifying device.
  • If you are younger than 25, you may either have to get a repeat pap test in one year or a colposcopy, depending on the results.

WHAT IS HPV?

HPV stands for human papillomavirus. HPV is spread by direct skin-to-skin contact to the genital area (sexual intercourse, oral sex, anal sex).  The risk of HPV infection increased with the number of sexual partners a person has. Both men and women can get infected. Usually, there are not signs or symptoms of an HPV infection and some even resolve without treatment.

DOES HPV CAUSE CERVICAL CANCER?

In 10-20% of women with HPV infection, the virus may persist. This leads to an increased chance of cervical cancer. Cervical cancer usually takes 10-20 years to develop from an HPV infection, and that is why regular screening though pap tests and HPV testing can help prevent cervical cancer.  There are dozens of different HPV virus subtypes. HPV-16 and HPV-18 are the two subtypes that are most associated with cervical cancer in the United States.

WHAT ARE THE RISK FACTORS FOR/CAUSES OF CERVICAL CANCER?

Infection with certain types of HPV (human papillomavirus) leads to increased risk of cervical cancer. Specifically, HPV types 16 and 18 are high risk for cervical cancer. Those who have multiple sex partners, smoke, or use medications that weaken the immune system are at risk of cervical cancer. It takes years for an HPV infection to become cervical cancer.

I'VE HAD THE HPV VACCINE. DO I STILL NEED SCREENING FOR CERVICAL CANCER?

Yes. There are over 100 subtypes of HPV. The HPV vaccines protect against only certain types of HPV (6, 11, 16, 18). These are the most common types in the United States associated with cervical cancer, but you still need screening because you can still get infected with other types.

WHAT IS COLPOSCOPY?

Colposcopy is a procedure that uses a colposcope to get a better view of cervical cells. A colposcope, is a magnifying device that makes seeing cervical cells easier.

WHY IS COLPOSCOPY DONE?

Colposcopy is often done after an abnormal pap test or HPV test or if there are abnormal areas on cervix, vagina or vulva like genital warts, cervicitis, polyps, pain and bleeding.

HOW IS COLPOSCOPY DONE?

Colposcopy takes 5-10 minutes and is done in the office. It is performed similarly to a pelvic exam. You will lie on your back, while a doctor uses a speculum to open your vagina.  The doctor will use a colposcope to look at your cervix. A Colposcope is like a microscope on a stand.  If there is abnormal tissue, the doctor will remove a small piece for a biopsy.

 

You should avoid the following at least 24 hours before the test: Douching, using tampons, vaginal medications and having sex.

WHAT SHOULD I EXPECT AFTER A COLPOSCOPY?

Most women feel fine and may return to work or school on the same day or following day. If you had a biopsy you may feel cramping, minor bleeding and vaginal discharge a few hours after the exam.

CALL YOUR DOCTOR IF YOU EXPERIENCE ANY OF THE FOLLOWING AFTER COLPOSCOPY

  • Vaginal bleeding for more than 7 days
  • Heavy vaginal bleeding (soaking through a pad in an hour)
  • Foul smelling vaginal discharge
  • Severe abdominal pain or cramps that do not get better with advil or motrin
  • Fever greater than 100.4°F
  • Chills

|    © 2014-2018 copyright Taraneh Shirazian, MD

wwc   ny

Joan H. Tisch Center for Women's Health

207 E 84th Street

New York, NY 10028

Phone: 646-754-3300

 

Email: info@wwcofny.com