Doctors recommend that women help reduce their risk of cervical cancer by having regular Pap tests. A Pap test (sometimes called Pap smear or cervical smear) is a simple test used to look at cervical cells. Pap tests can find cervical cancer or abnormal cells that can lead to cervical cancer.

Finding and treating abnormal cells can prevent most cervical cancer. Also, the Pap test can help find cancer early, when treatment is more likely to be effective.

For most women, the Pap test is not painful. It's done in a doctor's office or clinic during a pelvic exam. The doctor or nurse scrapes a sample of cells from the cervix. A lab checks the cells under a microscope for cell changes. Most often, abnormal cells found by a Pap test are not cancerous. The same sample of cells may be tested for HPV infection.

If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:

• Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor's office or clinic.
  
  
• Biopsy: Most women have tissue removed in the doctor's office with local anesthesia. A pathologist checks the tissue under a microscope for abnormal cells.
  • Punch biopsy: The doctor uses a sharp tool to pinch off small samples of cervical tissue.
  • LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of cervical tissue.
  • Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervix. Some doctors may use a thin, soft brush instead of a curette.
  • Conization: The doctor removes a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia.

Removing tissue from the cervix may cause some bleeding or other discharge. The area usually heals quickly. Some women also feel some pain similar to menstrual cramps. Your doctor can suggest medicine that will help relieve your pain.

For more information about tests, cell changes, and treatment for these changes, you may want to read Understanding Cervical Changes ¹. The NCI fact sheet Pap Test ² tells how often women should have Pap tests and how to prepare for them.

Glossary Terms

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

A lighted magnifying instrument used to examine the vagina and cervix.

Examination of the vagina and cervix using a lighted magnifying instrument called a colposcope.

Surgery to remove a cone-shaped piece of tissue from the cervix and cervical canal. Conization may be used to diagnose or treat a cervical condition. Also called cone biopsy.

A spoon-shaped instrument with a sharp edge.

A procedure in which the mucous membrane of the cervical canal is scraped using a spoon-shaped instrument called a curette.

A temporary loss of feeling and a complete loss of awareness that feels like a very deep sleep. It is caused by special drugs or other substances called anesthetics. General anesthesia keeps patients from feeling pain during surgery or other procedures.

A technique that uses electric current passed through a thin wire loop to remove abnormal tissue. Also called loop electrosurgical excision procedure and loop excision.

A temporary loss of feeling in one small area of the body caused by special drugs or other substances called anesthetics. The patient stays awake but has no feeling in the area of the body treated with the anesthetic.

A doctor who identifies diseases by studying cells and tissues under a microscope.

Removal of a small disk-shaped sample of tissue using a sharp, hollow device. The tissue is then examined under a microscope.