A WORD ABOUT PAP SMEARS

The Pap smear  has reduced the incidence of cervical cancer in the past 50 years or so. When I was a medical student at Cornell in the early 1940s, Dr. George Papanicolaou was doing his work on the cervical and vaginal smear. I never met him, but remember walking down the hall and looking into his laboratory and seeing him.

The Pap smear is not perfect, and false negatives probably occur in 1 to 2 percent of all smears. Although rare, these cases often receive a good deal of publicity. Recently commercial enterprises have developed new techniques for evaluating the smears. These companies have invested millions of dollars, and now hope to see a return on their investment. They are advertising heavily.

There a two different techniques: one involves the conventional Pap smear being read by a video microscope and a computer selecting images for review by the cytotechnologists and pathologists. The other technique (Thin PrepŠ) involves a new method of collecting the cells in fluid and then preparing slides that are reviewed by cytotechnologists and pathologists.

The liquid based pap smear is pretty much the standard now. 

Another change is that after the age of 30, if a woman has never had an abnormal pap, never had an infection with the papiloma virus (the virus that causes genital warts), then a pap smear need be done only every three years. You still need your annual GYN exam but a pap does not have to be done every time. 

The value of Pap screening has been shown over and over again. The real problem is that a very large number of women do not get Pap smears.

This page last updated
April 16 2005

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