The Pap smear is an essential part of routine preventive health care for all women, including sexually active adolescents and postmenopausal women. During this screening test for cervical cancer, cells are taken from the cervix. The vaginal walls are held open with a speculum, and a few cells are removed with a cervical brush or a small wooden spatula; these cells are put on a glass slide and sent to a laboratory to be examined. The cells for a Pap smear are taken from the transition zone, the part of the cervix where long, column-shaped cells called columnar cells meet flat-shaped cells called squamous cells. A Pap smear is not painful, because there are so few nerve endings on the cervix. A vaginal Pap smear is done when the woman’s cervix has been removed, although the incidence of vaginal cancer is low.
Since the development of Pap smears in 1941, early detection and follow-up treatments have decreased the death rate from cervical cancer by 75% in the United States (Dolgoff, 2008). Women throughout the world who are economically disadvantaged and do not participate in screening programs are far more likely to die from cervical cancer than are other women. For example, an average of only 41% of women across the developing world survive cervical cancer (Parry, 2006). Each year about 250,000 women in the developing world die of cervical cancer (Kalb & Springen, 2006).
Several factors increase the risk of developing cervical cancer. These include having sexual intercourse at an early age, having multiple sexual partners, smoking tobacco, inhaling secondary smoke, and having had certain sexually transmitted infections (Wyand & Arrindell, 2005).
The U. S. Preventive Services Task Force currently recommends that women have their first Pap smear at age 21 and have subsequent screenings every 3 years until age 30 and every 5 years between the ages of 30 and 65, depending on their health-care provider’s recommendations (Conley, 2012). Research has found that a different type of test for human papilloma virus (HPV), a sexually transmitted infection, is more effective than the Pap test in detecting cervical cancer, and in 2009 the test was approved by the FDA to screen for HPV and cervical cancer (Mechcatie, 2009). •