Q. What is a Pap smear?

A. Women often confuse a Pap smear with a pelvic exam. While the Pap smear can be done during a pelvic exam, the exam entails a bit more. The Pap smear is a simple test where the cervix (in the back of the vagina) is gently brushed and the cells are placed on a glass slide. This is somewhat like brushing the inside of your cheek with a popsicle stick.

The power of the Pap smear comes from the fact that cancer of the cervix takes many, many years to develop, and the doctor can find early signs of this development by looking at the cells on the glass slide. The drawback to the Pap smear is that is it not perfect; it misses some of the changes. For this reason, even though the cancer takes a long time to develop, we recommend the test be done more often.

Women at low risk (few sexual partners in the past, no history of an abnormal Pap, etc., a more complete list is available at http://www.cap.org/html/public/pap.html), getting the exam every 2-3 years is probably sufficient. For other women, the test should be done every year. Occasionally, your doctor may suggest a Pap smear every 6 months. Most women without a cervix, usually because she had a hysterectomy, does not need a Pap smear (but she may still need a pelvic exam).

If you are interested in an annual Pap smear, you can get a free e-mail reminder from the College of American Pathologists at http://www.papsmear.org/ . (Note the college believes all women should have an annual Pap smear.)

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