Early detection with regular pelvic examinations and Pap smears and being alert to symptoms and risk factors for cervical cancer is the key to successful treatment. The ACS recommends that women undergo an annual Pap test and pelvic exam beginning when they become sexually active or by the age of 18, depending on which comes first. After three or more consecutive normal Pap smears, the Pap test can be performed less frequently, at the physician's discretion. Menopause does not mean Pap smears and pelvic exams are no longer necessary. Women should continue to have regular Pap smears throughout their adult lives. However, after regular screening, Pap smears may be omitted in women over 65 who are low risk for developing cervical cancer.
Pap tests are not 100-percent accurate. A Pap smear may come back with a false-negative reading, meaning the laboratory reports that the tissue is normal when there is indeed an abnormality on the cervix. Or sometimes a false-positive reading may report an abnormality when there is none. Though rare, these errors occur and are a recognized limitation of any screening program. Abnormal cells may not be present in the sampled area, the number of abnormal cells may be too few for the laboratory personnel to see or the abnormal cells may be confused with normal cells.
Regular exams are recommended to guard against false-negative readings. Less than 1 percent of readings are false-negatives. The chances of an abnormality being missed drop dramatically with repeat regular screenings.
Newer technologies are being developed to improve the Pap smear. For example, in "thin-layer technology," sampled cervical cells are placed in liquid instead of being smeared directly on a glass slide in the office. A processor at the laboratory then deposits a single layer of cells on the slides. Manufacturers hope the new slide preparation will improve the likelihood that abnormal cells will be transferred from the cervix to the slide and be seen microscopically.
Additionally, regulations mandate that all laboratories recheck at least 10 percent of their negative or normal Pap smears for quality control. Additionally, patients can request that a Pap smear be re-screened. To reduce the instances of human error and the expense of human rechecks, technology has focused on creating automated rechecks. The FDA has approved two computer-assisted devices, AutoPap and PAPNET, to rescan negative Pap smears for improved accuracy.
When a Pap test detects abnormal cells, a doctor performs a biopsy (a surgical procedure to remove a tissue sample for examination) so that the tissue can be tested more extensively for pre-cancerous or cancerous cells.
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