Overview of the Pap Smear

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The page below is a sample from the LabCE course Human Papillomavirus (HPV) and Molecular Testing for Cervical Cancer (retired 2/17/2021). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Overview of the Pap Smear

Cervical cytology has been quite successful in the detection of cervical cancer. Since the carcinogenesis of cervical cancer is usually very slow, taking many years to decades to develop, cervical cytology can detect cervical cancerous or precancerous states in most cases. The Papanicolaou-stained smear (Pap smear) remains the primary screening test for cervical cancer. If regular Pap smears are performed, most cervical cancers can be detected and treated. In fact, cervical cancer is one of the most successfully treated cancers.
The test mainly examines the cervical smear for cervical dysplasia or pre-cancerous changes. There are two main types of Pap Tests, the conventional Pap and the liquid-based cytology Pap test. In the conventional Pap test or smear, the samples are swabbed and then smeared directly onto a microscope slide after collection. In the liquid-based cytology Pap test, the sample of epithelial cells is taken from the cervix with an arrow-shaped brush. The sample is then suspended in a bottle of preservative for transport to the laboratory where the specimen is analyzed using Pap stains. An HPV test may also be performed if the Pap result is abnormal or if both tests are requested. The sensitivity of a Pap smear is low at only 55%-80%; however its specificity is greater than 90%.
Further information regarding cell types and terminology associated with the Pap test/cervical cytology testing are provided in the PDF resource that can be accessed from this page.