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Pap test


What is a Pap test?

It's a test that detects pre-cancerous or cancerous lesions of the cervix. It is performed with a spatula and a small brush to collect a sample of cells that is "smeared" and fixed on a glass slide and sent to the lab for examination under a microscope.
It's a simple and painless test lasting a few minutes. The sample is generally collected by a midwife.

When should I have the test?

Women aged 25 to 64 should have the test when they receive a letter from their Local Health Authority inviting them to do so every three years. If you have not yet received the invitation letter but you are in this age group, you should consult your general practitioner for advice on the opportunity of having the test.

Why only women aged 25 to 64?

Starting screening at an early age may involve the detection of lesions that are very likely to regress spontaneously, risking therefore overdetection and overtreatment. Already after the age of 50, for a woman who has been regularly screened, the risk of developing cervical cancer is very low, that's why the screening programme stops at the age of 64.
If you have never had a Pap test and you are over 64, you should see you general practitioner who will give you the necessary information to have it.

Why screen for cervical cancer?

Periodically receiving the test is an effective way to detect the changes that precede the onset of a tumour by many years. In Tuscany the majority of women who every year develop a cervical tumour have never had a Pap test.

What does the test detect?

The Pap test detects pre-cancerous and/or cancerous lesions of the cervix even when they are very small and in the absence of symptoms.

How do I prepare for the test?

For a successful test it is necessary: to collect the sample at least three days after the end of the menstrual cycle, in the absence of bleeding;
not to have sexual intercourse for two days before the test;
to avoid the use of vaginal suppositories, creams or douches for three days before the test.

How much does it cost?

The test is free of charge for women aged 25 to 65 if the National Health System has not already paid for this test during the three previous years.

Is a General Practitioner's prescription required?

A General Practitioner's prescription is not required for the women receiving the invitation letter from their Local Health Authority.

Can I directly make an appointment for the test?

If you have not received the invitation letter, consult your general practitioner who decides whether you should have the Pap test.

Is it possible to be given leave from work to have the test?

Yes, on your request.

May I take drugs before the test?

There are no problems if drugs are taken orally or intramuscularly, while the use of local medicines like vaginal suppositories, creams or douches should be avoided for three days before the test

Can I change the time and date of my appointment?

Yes, in the invitation lettere there are all the necessary instructions to change your appointment.

May I have a Pap test if I'm pregnant?

Generally speaking having a Pap test during pregnancy is not contraindicated. However it is advisable to have it before the end of the eight month. After the test there may be minor bleeding with no influence on the evolution of pregnancy.

How accurate is a Pap test?

The Pap test is an effective method to prevent invasive cancer of the cervix. Like any other test, however, it has some limits and may generate false positives (abnormal results in healthy persons) or false negatives (normal results in subjects with a lesion). A variety of factors may contribute to a false negative : the lesion has not been reached when collecting the cells, or it does not shed cells, or cells are masked by blood or inflammation. In spite of this, the pre-clinical phase is very long, and the lesion may be identified at the next screening.

Is it possible for a tumour to occur after a negative Pap test?

Though very rarely, it is possible for a cervical tumour to develop after a negative test and before the following screening (interval cancer). If you notice abnormalities , you should immediately see your general practitioner.

How do I receive the test results?

If the test is negative, you will receive the results by mail. If the result is equivocal, the screening centre will call you to arrange further investigations.

If I'm called by the centre for further investigations, which tests should I have?

You may be called to have other lab tests or to be referred for colposcopy, an oupatient examination allowing the doctor to directly examine the cervix. The recall should not worry you: initially suspicious changes are often ruled out by further tests and exams.

And while waiting for the next call?

If while waiting for the next call you notice abnormalities, you should see your general practitioner.

Are the pap-test and the bacteriological smear the same thing?

No, there are two types of vaginal smears:
the oncologic smear (or Pap test) is performed to detect lesions that may transform into tumours;
the bacteriological smear (or bacterioscopy) is performed to discover the causes of inflammation and to find the most suitable treatment (to be carried out when the doctor deems it necessary).

What is colposcopy?

It's an outpatient test performed to examine the cervix with a colposcope, an instrument with a light source and a magnification device. The cervix is examined through a magnifying lens after the application of a fluid that enhances lesions in the cervical tissue. Whenever abnormalities are detected, the doctor may decide to perform a biopsy (removal of a small amount of cervical cells) that is sent to the lab for examination under the microscope.