Pap Smear

Pap smear: Saving Lives Since 1943

The Pap smear is a screening tests for cervical, vaginal and endocervical cancer. To be more specific, a physician looks in and up the vaginal canal with a clear vaginal speculum, opening the vaginal canal to see the vagina and cervix. The cervix, respectfully, physically appears exactly like the tip or head of the male genitalia - it has the same curve and shape with a hole/opening at the tip called the cervical "os".
A Pap smear looks for abnormal cells in and around the cervical OS (tip). The "smear" is a scraping from the borders of the OS and a scraping of the vaginal wall around the rest of the cervix a soft brush is inserted into the OS to collect cells for microscopic analysis. The scraping is usually almost painless and is like a Popsicle stick rubbing across your hand. These scrapings are read by a pathologist in the laboratory. What the pathologist looks for is multiple nuclei in the cells, lots of inflammatory reaction involving the cells, or an excessive number of immature cells suggesting possible, probable, or definite cervical cancer or vaginal. A scraping of the vaginal wall is done as well. Vaginal cancers are rare, but unfortunately, do occur.
The confusion lately with Pap smears is because of the study on genital warts (virology). These warts are often seen on men and may be seen rectally, vaginally, or on the labia in women. They contain a Papilloma virus. This virus has around 20 different types, 4 of which can cause cervical cancer. The proper evaluation of this Papilloma virus causing genital warts and the specific small percentage of types that cause cervical cancer is where the confusion starts. Everyone who has genital or anal warts does not necessarily get cervical cancer. Even so, people who have had genital warts treated or untreated may develop a percentage of the cases of cervical cancer.
A new vaccine, primarily for women ages 9 to 25 years, has been approved by the FDA to help prevent this viral infection before it is transmitted. It will not cure an already existing infection. Much more recently, this immunization has become available for young men in the same age group who do not have the virus. This vaccine is to protect them from getting genital warts and spreading them to others. It does not cure an already present infection.
Genital warts can usually be diagnosed by inspection and sometimes require careful magnification. They can be very small or very large. Usually, the warts need to be surgically removed. They almost always require surgical removal at some point to avoid the infection, invasion, or spread. They can grow to a very large size and be extremely irritating, unsanitary, and cosmetically inappropriate. Rarely may they grow to the size of a hockey puck, peach or plum. Any sexually active person having had, or thought to have had, exposure to genital warts usually needs a medical examination. For women, the annual Pap smear and pelvic exam may be the best avenue for this purpose. Other tests for such problems as Chlamydia may be recommended. When in doubt, always see your doctor.
John Drew Laurusonis, MD
Doctors Medical Center