ADOLESCENT MEDICINE :: Urologic or Gynecologic Problems
What is a Pap test?
A Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix, or the "mouth" of the womb (located at the top of the vagina), for the presence of:
Why is a Pap test suggested for females?
A Pap test, along with a pelvic examination, is an important part of a female's routine healthcare because it may detect abnormalities that can lead to invasive cancer. Most invasive cancers of the cervix can be detected early if females have Pap tests and pelvic examinations regularly. As with many types of cancer, cancer of the cervix is more likely to be successfully treated if it is detected early.
But, the Pap test is not only useful in detecting cancerous cells, it can detect other changes in the cervix and vagina, including dysplasia, or pre-cancer cells. Inflammation in the cervical area may also be detected. Inflammation may be caused by:
Abnormal Pap Results
According to the National Cancer Institute, when the Pap test shows an ambiguous or minor abnormality, the test is usually repeated to ensure accuracy.
If the test shows a significant abnormality, a colposcopy may be performed (using an instrument called a colposcope) to examine the vagina and the cervix.
A Schiller test may also be performed, in which the cervix is coated with an iodine solution.
A biopsy may be performed in which the physician removes a small amount of cervical tissue for examination by a pathologist. This is the only sure way to determine whether the abnormal cells indicate cancer.
Who should have Pap tests?
A woman should always consult with her physician about when and how often a Pap test and pelvic examination should be performed.
According to the National Cancer Institute (NCI), the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG), general guidelines include:
Thinprep - A Pap test alternative:
A new way of testing cervical cells for abnormalities is gaining acceptance in the medical community. Though the cost of the procedure, call Thinprep, is double what a Pap test costs, studies show that Thinprep may require fewer repeat test and detects more early-stage lesions. Approved by the US Food and Drug Administration (FDA), Thinprep is a liquid-based procedure in which cells from the cervix are put into a vial of liquid instead of being "smeared" onto a slide. The liquid is then filtered and only the cervical cells are placed onto a slide for examination. Consult your physician for more information.
Adolescents and abnormal Pap test results:
When abnormal cells are identified on a Pap test, additional testing is generally recommended in order to determine if the abnormality requires treatment. However, a 2006 report from the American College of Obstetricians and Gynecologists (ACOG) recommends that abnormal Pap test results in adolescents may be managed somewhat differently.
Most cervical lesions of a lower grade will go away without treatment in adolescents. Thus, ACOG's current recommendation is to repeat the Pap test at 6- or 12-month intervals for a year after the original abnormal Pap test, depending on the individual situation of the adolescent involved. However, the plan of action for further testing and treatment after abnormal results from a Pap test will depend on the type of abnormality found and the adolescent's general health status.
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It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.
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