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