What is a cervical smear?
A cervical cytology test is done in the doctor's office during a regular pelvic exam. For the test, a speculum is placed in the vagina, and a sample of cells is taken from the outside of the cervix (or neck of the womb). These cells then are spread onto a glass slide and given to a lab for analysis (cervical smears or Pap tests) or they are collected to fluid filled bottles (liquid based cytology). This allows detection of pre-cancerous abnormalities of the cervix at an early stage when there is no sign of disease and treated successfully before cancer develops. It is not unusual sometimes smears to be reported as abnormal even though no abnormality exists on further examination. In extremely rare cases, smears may detect an abnormality in the presence of a cancer of the cervix. The cervical cytology test is a screening test which signal that more careful attention should be directed at the cervix (i.e. colposcopy examination) if there is significant abnormality or a minor abnormality persists.
How smear result are graded
Smears are graded with differing degrees of abnormality from a non specific ‘borderline’ change to mild, moderate and severe changes called dyskaryosis and these roughly equate to CIN 1, 2 and 3. Borderline change requires a colposcopy appointment (see what is colposcopy) only if the abnormality remains after repeat testing and usually after 2-3 such smears taken at 6 monthly intervals, because the risk of a pre-cancerous abnormality here is very small.The reason for this is that a lot of minor smear abnormalities go back to normal after several months. If the smear shows mild changes you may be referred to colposcopy clinic or asked to have another smear in 6 months and then referred to colposcopy clinic only if the abnormality persists. If the changes are more abnormal,l then referral is made without the need for a further smear.