Anatomic Pathology Services - Pap Test
The Pap Test (Smear) has been the recipient of much criticism over the past few years. Isolated negative experiences have been generalized. However, the fact remains that in the highly screened population (many women getting Pap Tests), the cervical cancer rate is approximately 80% lower than in the unscreened population (few women getting Pap Tests).
Misconceptions arise from the fact that women believe that Pap Tests are highly accurate. In fact, the Pap Test is a "screening" test rather than a "diagnostic" test. This means that the results of the test should only assign a probability that the disease exists in an individual. There are chances for error in both the collection of the specimen by the clinician and interpretation of the smear by the cytotechnologist or pathologist. It is estimated that there is an unavoidable false negative rate (meaning that abnormal cells are present when a diagnosis of "normal" is received) of about 5%. The unavoidable false negative samples result from inadequate specimen collection (the abnormal cells were not picked up by the brush or spatula used to obtain the sample from the cervix) or by errors in screening. The latter can result from the presence of only a few abnormal cells hiding among millions of normal cells.
Alternatively, abnormal cells may be present but misidentified as cells that are not concerning (for example, a fungus infection or trauma can illicit an abnormal cellular response, but this does not indicate that a pre-malignant condition exists).
The most important thing to note is that the Pap test is a great test, but not a perfect test. There are certain things that a woman can do to assure that the most optimal testing is being provided:
Make sure you have a Pap Test every 1-3 years, as directed by your physician.
Do not have a Pap Test taken during your menstrual period. The optimal time for having a Pap Test is mid-way during the menstrual cycle.
Do not use a douche preparation before the Pap Test is to be taken.