A pap smear is part of a gynaecological examination. A sample of cells is taken from the cervix and screened for abnormal cells and cervical cancer. The United States Preventative Task Force recommends that after three normal pap smears done annually, a smear test every two to three years is sufficient.
The gynaecological evaluation includes a pelvic examination, the collection of the specimen, preservation of the specimen and microscopic review of the specimen.
A gynaecological exam bed with stirrups helps position the patient. Various speculums are used, depending on the size of the vagina. The Grave's speculum comes in three sizes: small, medium and large. The Grave's medium will fit most women. A Pederson speculum is narrower than a Grave's and is used in women who have never been pregnant, have never used tampons, or have narrow vaginal openings because of age, radiation or surgery. Another speculum is of a disposable plastic and is used successfully in most women.
Collection of Specimen
Collection is achieved by using a cytobrush applicator and an Ayer's spatula. The specimen is then either placed on a slide or washed into a liquid solution for examination.
Preservation of Sample
There are two general methods of preserving the cervical sample, slide fixation and liquid-based cytology. To fix the specimen, a slide is used and the cytobrush and spatula are run across the glass and sprayed with a fixative solution. In a liquid-based sample, the cytobrush and spatula are rinsed through the liquid container and sealed for examination. The sample is then sent to a pathology lab for examination.