A cervical smear, also called a Pap smear or a Pap test, is a diagnostic test routinely performed by doctors to check the health of the cervix. To perform this test, a doctor uses a uses a wooden scraper to remove a small sample of cells from the cervix. These cells are placed on a glass slide and sent to a laboratory for analysis. By analyzing the appearance of the cervical cells, abnormal and possibly cancerous cells can be identified.
Normal Cells
If the cervical cells appear normal, the results are "normal" or "negative." No cellular abnormalities are detectable, and no further testing or treatment is needed until it is time for the next regular cervical smear.
Atypical Cells
If the cells appear abnormal, they may be one of several different types. One type of abnormal cells, described by the National Cancer Institute, is "atypical." When cells of the cervix do not appear normal, but also do not appear to be cancerous, the doctor classifies them as atypical, which literally means "not normal." Both squamous and glandular cells can be identified as atypical. Squamous cells are flat thin cells that line the surface of the cervix and glandular cells are the mucus-producing cells of the cervix. Some atypical cells may be precancerous, but doctors are generally uncertain about whether these cells will definitely become cancerous.
Squamous Intraepithelial Lesion
The squamous cells of a squamous intraepithelial lesion appear more abnormal under a microscope than atypical squamous cells. These changes may be low-grade, meaning the appearance of these cells are somewhat abnormal, or they may be high-grade, meaning there is a higher risk of the cells becoming cancerous in the near future. Intraepithelial cells are cells that form the surface of the cervix. Low-grade squamous intraepithelial lesions often heal without treatment, whereas high-grade squamous intraepithelial lesions are indicative of more high-risk changes.
Cancerous Cells
When cells from a cervical smear appear greatly abnormal, the doctor may diagnose cervical cancer. This diagnosis may mean that the cancerous cells have spread from the surface and deeper into the tissue of the cervix. When cancerous cells are found, treatment and further testing is definitely required. The pathologist can tell from the appearance of the cells the type of cancer. Two common types of cervical cancer are squamous cell cancer and adenocarcinoma, which stem from the squamous cells and the glandular cells, respectively.
