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Pap Smear

Pap Smear

Pap smear or Pap test is conducted as part of a woman's routine health examination, after the age of 21 years. It is not a diagnostic test but is a screening tool used to detect any abnormal cells in the cervix. The cervix is the lower part of the uterus that opens into the vagina.

Pap smears help in early detection of any serious medical conditions such as cervical cancer.

Abnormal Pap smear may indicate the presence of infection or abnormal cells called dysplasia. An abnormal Pap smear may not necessarily denote cancer. These results highlight the requirement of supplementary testing to identify and confirm an underlying problem.

Causes of Abnormal Pap Smear

An abnormal pap smear may indicate any of the following:

  • An infection or an inflammation
  • Herpes
  • Trichomoniasis
  • Dysplasia (abnormal cells that may be pre-cancerous)
  • Recent sexual activity
  • HPV (Human Papilloma Virus) infection; also called genital warts


Usually, abnormal cells do not produce any symptoms. Moreover, even the presence of HPV in an abnormal Pap smear is asymptomatic. Therefore, a regular Pap smear is beneficial in the early detection of any abnormalities.

However, an abnormal Pap smear secondary to a sexually transmitted infection may induce the following symptoms:

Abnormal discharge from the vagina, such as a change in the amount, colour, odour, or texture
Abnormal sensations such as pain, burning or itching in the pelvic or genital area during urination or sex
Sores, lumps, blisters, rashes, or warts on or around the genitals


Following an abnormal Pap smear, the next step is further testing to confirm the cause of the abnormal cells. A repeat Pap smear or test for human papillomavirus (HPV), a major risk factor for cervical cancer, may also be recommended.

Depending on the age of the patient and the type of abnormal cells, the doctor may recommend the following treatment options:

Cryosurgery: It involves freezing the abnormal cells which are then surgically removed.
Cone biopsy or Loop electrosurgical excision procedure (LEEP): In this procedure, a triangle segment of cervical tissue including abnormal cells is removed by specially designed instruments for evaluation.

Abnormal Pap Smear During Pregnancy

A Pap smear during pregnancy is very safe. In case of an abnormal Pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby. Often, the birth process washes away the abnormal cervical cells.

Related Topics

  • British Gynaecological Cancer Society
  • British Fertility Society
  • British Menopause Society
  • BSGE
  • General Medical Council
  • National Association for Premenstrual Syndrome
  • Royal College of Obstetricains and Gynaecologist