The Essential Pap Smear
A Pap smear is a simple test carried out during a woman's internal (pelvic) exam. Your health care provider performs a vaginal exam with a speculum (a tool used to separate the vaginal walls to view the cervix), and uses a cotton swab, small brush, or small wooden spatula to painlessly scrape a cell sample from both the inside and the outside of the cervix (the tip of the uterus). If you can feel anything, it feels most like rubbing the back of your hand with your finger. These cells are then spread on a slide, sprayed with a fixative, and sent to a lab where the slides are screened for abnormalities by a cytotechnologist (trained technician) and reviewed by a cytopathologist (medical doctor), if necessary.
If you have not had a Pap smear in the past year, take a break from reading this article right now and call your doctor to schedule one.
The Importance of Having Regular Pap Smears
The Pap smear is the most important screening test to detect early evidence of cervical cancer. It can also detect many other infections and cervical abnormalities. Since its introduction in 1939, the Pap smear has led to a 75% drop in cervical cancer deaths in the US. Yet in 1997, a Gallup survey commissioned by the College of American Pathologists found that although nearly 9 out of 10 women surveyed knew they should have a Pap test every year, nearly 4 out of 10 of these women had failed to do so in the previous year.
The figures for some individual ethnic groups are even more worrisome. According to the US Department of Health and Human Services (HHS), one out of every 3 Hispanic women reported that they had not received a Pap test in the preceding three years, compared with one in every 4 American women in general. Of even greater concern is the fact that the rate of death for African American women from cervical cancer is nearly twice that of Caucasian women.
Each year in the United States, approximately 16,000 women are diagnosed with invasive cervical cancer and tragically, nearly 5,000 die annually of this disease. Of the 5,000 women per year who die of cervical cancer, most had not had a PAP smear in over 5 years! Prior to the use of the Pap smear, the cervical cancer rate in the US was 44 cases per 100,000 women; now it is 7 cases per 100,000 women. Globally, however, fewer than 5% of women have had a Pap smear and more than 80% of cervical cancer cases worldwide occur in developing countries.