The Pap Smear: Why You Might Need It, Why You Might Not

By Lauren Streicher, MD Asst. Clinical ProfessorObstetrics and Gynecology The Feinberg School of Medicine

Posted on | By Lauren Streicher, MD

Pap smears are like routine car service. You’re not exactly sure what they are checking for, but you know you should do it.  Even well-informed women who know that a Pap test is primarily a screen for cervical cancer are still unsure as to whether it also checks for sexually transmitted infection, ovarian cancer, uterine cancer and general “gynecologic wellness.” So, what exactly is a Pap test?

In 1928, after spending months observing his own wife’s cervical cells under a microscope, Dr. George Papanicolaou invented the Pap smear as a method to detect cervical cancer. His discovery has stood the test of time. And Dr. Papianicolaou can be credited with the fact that cervical cancer is now a rare cause of death in the US in spite of the fact that it remains the leading cause of death in countries where Pap smears are not routinely done. (Though it seems Mary Papanicolaou should get at least some of the credit after submitting to countless Pap smears to support her husband’s research!)

Most women are familiar with the basic process: a speculum is inserted into the vagina in order to sample cells from the surface and canal of the cervix. The cells are then sent to a lab where they are checked for abnormal cell growth, also known as dysplasia, cervical intraepithelial neoplasia or CIN.

Every year, more than 3.5 million women get that stomach-dropping “Your Pap smear is abnormal” notification. But even if dysplasia is detected, the chance of a real cervical cancer is small. Out of that 3.5 million, only 13,000 are likely to have a true cancer. The rest will either ultimately be found to have nothing wrong with their cervix, or a dysplasia which is easily treated or, even more likely, goes away on its own.

Article written by Lauren Streicher, MD
Asst. Clinical Professor, Obstetrics and GynecologyThe Feinberg School of Medicine