PAP Smear - Conventional
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Screening test for cervical cancer and precancerous changes
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🧪 What is a PAP Smear – Conventional?
The Papanicolaou (PAP) smear – Conventional method is a screening test for cervical cancer and precancerous changes. It involves collecting cells from the cervix, smearing them directly onto a glass slide, and examining them under a microscope for abnormalities.
Unlike Liquid-Based Cytology (LBC), in conventional PAP smear the sample is not suspended in fluid but directly fixed on a slide.
❓ Why is the Test Done?
To:
- Detect cervical cancer and pre-cancerous lesions (CIN – Cervical Intraepithelial Neoplasia)
- Monitor cervical health, especially in women over 21
- Assess infections, inflammation, or hormonal changes
- Identify HPV-related cellular changes
👩⚕️ Who Should Get It?
Women Aged | Recommendation |
|---|---|
21–29 | Every 3 years (PAP only) |
30–65 | Every 3–5 years (PAP with or without HPV test) |
>65 or post-hysterectomy | Usually not needed unless high-risk history |
🧫 How It’s Done
- A speculum is inserted into the vagina
- A brush/spatula collects cells from the cervix
- Cells are smeared on a glass slide, fixed, and sent to lab
- Examined under microscope by a pathologist using the Bethesda System
📊 Normal & Abnormal Results (Bethesda System)
Result | Meaning |
|---|---|
NILM | Negative for intraepithelial lesion or malignancy |
ASC-US | Atypical squamous cells of undetermined significance |
LSIL | Low-grade squamous intraepithelial lesion (mild dysplasia) |
HSIL | High-grade SIL (moderate/severe dysplasia, CIN 2/3) |
AGC | Atypical glandular cells – needs further evaluation |
SCC or Adenocarcinoma | Suggestive of cervical cancer |
🧠 Associated Organs & Conditions
Organ/System | Conditions Detected |
|---|---|
Cervix | CIN, cervical cancer, HPV-related changes |
Vagina | Vaginitis, atrophy, inflammation |
Hormonal | Atrophic changes (menopause), progestin/estrogen imbalance |
🔄 Related / Follow-Up Tests
- HPV DNA Testing
- Colposcopy + Cervical Biopsy
- Liquid-Based Cytology (LBC)
- Endometrial sampling (if AGC)
- Repeat PAP smear in 6–12 months (ASC-US or LSIL)
✅ Fasting Required?
Test | Fasting Requirement |
|---|---|
PAP Smear – Conventional | ❌ No |
However, avoid douching, intercourse, vaginal creams, and tampons for 24–48 hours before test.
📝 Summary Table
Parameter | Details |
|---|---|
What | Microscopic exam of cervical cells for cancer/pre-cancer |
Why | Screen for cervical cancer, monitor cervical health |
Normal Result | NILM – Negative for intraepithelial lesion or malignancy |
Abnormal Results | ASC-US, LSIL, HSIL, AGC, SCC |
Associated Conditions | HPV infection, CIN, cervical carcinoma, vaginal inflammation |
Follow-up Tests | HPV test, biopsy, colposcopy, repeat PAP |
Fasting Required | ❌ No, but avoid vaginal products/intercourse 1–2 days prior |
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