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All women who are or have been sexually active, or are age 18 or older, should have regular gynecological checkups, including a pelvic exam and Pap test, to detect any abnormal changes to the cervix as early as possible. As with many types of cancer, cervical cancer is more likely to be successfully treated if it is detected early. Pap tests can also detect inflammation caused by yeast infections; bacterial infections such as trichonomas, gonorrhea, or Chlamydia; other viruses; medications or other chemicals; hormones; and pregnancy.
A pelvic exam is an internal exam of the uterus, vagina, ovaries, fallopian tubes, bladder and rectum. You will need to lie down on an examining table and put your feet in the stirrups. Next, an instrument called a speculum is inserted into your vagina to hold your vaginal walls open so your physician can view the inside of the vaginal walls and the cervix, and collect a sample of cervical tissue for your Pap test.
During a Pap exam, cells are collected with a cervical brush from the so-called “transformation zone” of the cervix (the most likely location for lesion development). The cells collected are used to detect any changes that may be cancerous or may lead to cancer, and to show noncancerous conditions such as infection or inflammation. The gynecologist or other health care practitioner performing the exam will spread the cells onto a slide and send them to a lab for further analysis.
If the Pap test shows an ambiguous or minor abnormality, the test is usually repeated to ensure accuracy. If the test shows a significant abnormality, your doctor may perform a procedure called a colposcopy to further examine the vagina and the cervix. For this test, performed in the gynecologist’s office, you will be positioned on the examining table like for a Pap smear, and an acetic acid will be placed on the cervix. The doctor will position an instrument called a colposcope – an electric microscope – close to your vagina. A bright light on the end of the colposcope lets the doctor clearly see the cervix. Abnormal cervical changes appear as white areas -- the whiter the area, the worse the cervical dysplasia. Your doctor may also perform a biopsy, in which a small amount of cervical tissue is removed and sent to a lab for analysis. This is the only sure way to determine whether the abnormal cells indicate cancer. You may want to take Motrin right before your appointment. Expect to have some spotting afterwards, so bring a sanitary napkin with you.
Depending on the results of your colposcopy exam and biopsies, your physician will discuss your treatment options.