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PAP Smear - Conventional

Cancer
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Report in 48Hrs

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At Home

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No Fasting Required

Details

Screening test for cervical cancer and precancerous changes

₹429₹825

48% OFF

PAP Smear - Conventional: Comprehensive Medical Test Information Guide

  • Why is it done?
    • Test Purpose: The conventional PAP smear is a screening test designed to detect precancerous and cancerous changes in the cells of the cervix. It involves collecting cells from the cervical surface and examining them under a microscope to identify abnormalities.
    • Primary Indications: Routine cervical cancer screening in asymptomatic women
    • Detection of human papillomavirus (HPV)-related cellular changes
    • Identification of infectious organisms (bacterial vaginosis, Candida, Trichomonas)
    • Assessment of hormonal status and cellular changes related to estrogen levels
    • Typical Timing: Recommended every 3 years for women aged 21-65 with normal results; annually for women with risk factors or abnormal history; at initial gynecological visit or upon request; not recommended for women under 21 or over 65 unless specific risk factors present
  • Normal Range
    • Normal Result (Negative): "No intraepithelial lesion or malignancy" (NILM) - This is the normal finding indicating no precancerous or cancerous changes detected in the cervical cells. Cytology shows normal squamous epithelial cells with normal maturation, no dysplasia, no evidence of HPV-related changes.
    • Units of Measurement: Descriptive cytological classification using the Bethesda System categories rather than numerical values
    • Result Categories:
    • • NILM (Negative for Intraepithelial Lesion or Malignancy) - Normal • ASC-US (Atypical Squamous Cells of Undetermined Significance) - Borderline • ASC-H (Atypical Squamous Cells, Cannot Exclude HSIL) - Borderline/Abnormal • LSIL (Low-Grade Squamous Intraepithelial Lesion) - Abnormal • HSIL (High-Grade Squamous Intraepithelial Lesion) - Abnormal • SCC (Squamous Cell Carcinoma) - Abnormal/Malignant • Adenocarcinoma - Abnormal/Malignant
    • Specimen Adequacy: "Satisfactory for evaluation" indicates adequate cellular representation; "Unsatisfactory" requires repeat sampling
  • Interpretation
    • NILM (Negative): No dysplasia or malignancy detected. Normal cervical cytology with appropriate maturation and no HPV-related changes. Routine screening continued at normal interval.
    • ASC-US (Atypical Squamous Cells of Undetermined Significance): Abnormality present but does not meet criteria for dysplasia. Requires HPV testing or repeat cytology in 12 months. Approximately 15-20% have underlying HSIL.
    • ASC-H (Atypical Squamous Cells, Cannot Exclude HSIL): Cytologic abnormality suspicious for HSIL. Requires colposcopy. Higher risk for dysplasia (25-40% may have HSIL).
    • LSIL (Low-Grade Squamous Intraepithelial Lesion): Mild dysplasia present, typically HPV-related. Approximately 40-50% resolve spontaneously, 30-40% persist, 20% progress to HSIL. Colposcopy recommended.
    • HSIL (High-Grade Squamous Intraepithelial Lesion): Moderate to severe dysplasia with significant risk of progression to cancer if untreated. Mandatory colposcopy and biopsy. Approximately 30% progress to invasive cancer within 30 years if untreated.
    • SCC (Squamous Cell Carcinoma): Invasive cancer present. Requires immediate gynecologic oncology referral and comprehensive staging/treatment planning.
    • Adenocarcinoma: Endocervical or other glandular cell malignancy detected. Requires immediate referral to gynecologic oncology.
    • Factors Affecting Interpretation:
    • • Specimen quality and adequacy • Timing of collection within menstrual cycle • Recent sexual intercourse, menstruation, or douching • Presence of inflammatory cells or infection • HPV status and type • Patient age and immune status • Hormonal status and estrogen levels • Prior cervical procedures or history of abnormalities • History of DES exposure in utero
  • Associated Organs
    • Primary Organ System: Reproductive system - specifically the cervix (lower portion of the uterus), which is lined with squamous epithelial cells
    • Diseases and Conditions Associated with Abnormal Results:
    • • Cervical intraepithelial neoplasia (CIN) • Cervical cancer (squamous cell carcinoma and adenocarcinoma) • Human papillomavirus (HPV) infection, particularly high-risk types (HPV-16, HPV-18) • Bacterial vaginosis • Candidiasis (yeast infection) • Trichomonas infection • Herpes simplex virus (HSV) infection • Inflammatory cervicitis • Atrophic vaginitis • Reactive cellular changes from inflammation
    • Risk Factors for Abnormal Results:
    • • Chronic HPV infection (particularly high-risk types) • Early age of first sexual intercourse • Multiple sexual partners • Immunosuppression (HIV/AIDS, post-transplant) • Tobacco use • Oral contraceptive use for extended periods • Multiparity • Family history of cervical cancer • Prior cervical abnormalities • DES exposure in utero
    • Potential Complications if Abnormalities Go Untreated:
    • • Progression of dysplasia to invasive cervical cancer • Metastatic disease if cancer develops • Potential need for more aggressive surgical treatment • Loss of fertility if hysterectomy required • Persistent HPV infection • Recurrent dysplasia after treatment • Morbidity and mortality from untreated cervical malignancy
  • Follow-up Tests
    • HPV (Human Papillomavirus) Testing: Reflex HPV testing recommended for ASC-US results; co-testing with PAP in initial screening; HPV-16 and HPV-18 specific genotyping for risk stratification
    • Colposcopy: Recommended for ASC-H, LSIL, HSIL, or positive HPV results; direct visualization of cervix with magnification; allows targeted biopsy of abnormal areas
    • Cervical Biopsy: Performed during colposcopy for histologic confirmation of dysplasia or malignancy; can obtain multiple samples from abnormal-appearing areas
    • Endocervical Curettage/Sampling: May be performed during colposcopy if lesion extends into endocervical canal or PAP showed glandular abnormalities
    • Repeat PAP Smear: Recommended in 12 months for ASC-US if HPV unavailable; after treatment of dysplasia for surveillance; annual screening for 25 years post-treatment of HSIL
    • Excisional Procedures: Loop Electrosurgical Excision Procedure (LEEP) or cold knife conization performed for HSIL confirmation and treatment; allows histologic evaluation of entire lesion and margins
    • Monitoring Frequency After Abnormal Results:
    • • ASC-US: HPV testing or repeat PAP in 12 months • LSIL: Colposcopy; post-treatment surveillance with PAP/HPV co-testing at 12 and 24 months • HSIL: Colposcopy and excisional treatment; PAP and HPV co-testing every 6 months for 2 years after treatment, then annually for 25 years • Negative post-treatment: PAP/HPV co-testing annually for 25 years; if HPV becomes negative after 2 negative tests, return to 3-year screening • Normal NILM: Routine screening every 3 years
    • Complementary Tests:
    • • HIV testing for immunocompromised patients • STI screening (chlamydia, gonorrhea, syphilis) • Pelvic imaging (ultrasound or MRI) if malignancy suspected • Chest imaging if invasive cancer diagnosed for staging purposes
  • Fasting Required?
    • Fasting Required: No
    • Patient Preparation Instructions:
    • • Avoid douching for at least 24 hours before the test • Avoid sexual intercourse for at least 24 hours before the test • Avoid vaginal medications, creams, and suppositories for 24-48 hours before the test • Avoid use of tampons for at least 24 hours before the test • Avoid intrauterine contraceptive devices (IUDs) insertion within 4 weeks of PAP smear • Schedule PAP smear approximately 10-20 days after the start of the menstrual cycle (avoid during menstruation if possible) • Empty bladder and bowel before appointment if possible • Wear comfortable, easily removable clothing • Do not use contraceptive foams or gels 24 hours before test
    • Medications to Avoid:
    • No specific medications must be discontinued for PAP smear; however, certain vaginal medications should be avoided for 24-48 hours before the test to prevent specimen interference: • Vaginal antifungal creams or suppositories • Vaginal antibiotics or antimicrobial agents • Estrogen creams or hormonal vaginal preparations • Spermicides or contraceptive foams • Mineral oil or petroleum jelly • Retained oral medications do not typically affect results
    • Test Duration: Approximately 5-10 minutes for specimen collection; results typically available within 1-2 weeks
    • After Test Instructions:
    • • Can resume normal activities immediately • May experience light vaginal spotting or bleeding (minor) • Avoid sexual intercourse, tampons, and douching until any light bleeding stops • Can use pads if light spotting occurs • Take over-the-counter pain reliever if mild cramping develops • Contact healthcare provider if heavy bleeding, severe pain, or fever develops • Avoid strenuous exercise for remainder of day if desired • Results will be communicated by healthcare provider, typically within 1-3 weeks

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