How does the Pap test work?
The Pap test is carried out in two steps: First, the doctor takes a cell sample from the cervix. The cells are assessed in a specialized laboratory.
As part of the gynecological examination, the doctor carefully opens the vagina with a speculum to gain access to the cervix. He then uses a small brush to scrape cells from the cervical canal. This is not usually painful, but sometimes a little uncomfortable.
What do the results of the Pap test mean?
The cells stained in the laboratory are assessed under the microscope to determine whether and how they have changed. The result of this examination is given as the Pap value.
The possible Pap values and their meaning
The following table lists the possible Pap values (according to Munich Nomenclature III) and how they determine the further procedure:
|
Pap value |
Meaning |
Further procedure |
|
Pap 0 |
Smear not assessable (usually for technical reasons) |
Smear test should be repeated |
|
Pap 1 (I) |
inconspicuous findings |
next smear test at the normal screening interval |
|
Pap 2a (IIa) |
Check the swab if necessary |
|
|
Pap 2 (II) |
Some cells insignificantly or slightly altered, but not yet precancerous or cancerous. |
Repeat smear test after one year, if necessary with further tests such as vaginal endoscopy (colposcopy). Further examinations are recommended for findings II-e. |
|
Pap 3 (III) |
No cancer, but conspicuous cell changes that cannot be clearly determined. |
|
|
Pap 3D (IIID) |
Mild (IIID1) to moderate (IIID2) cell changes of possible precancerous stages. Low risk of the changes developing into cancer cells. Often occurs in young women. |
Wait-and-see check-up because the changes often disappear on their own. If a check-up reveals the same findings, further examinations are recommended (e.g. colposcopy). |
|
Pap 4a (IVa) |
Severe cell changes or cancer at an early stage (carcinoma in situ). |
|
|
Pap 4b (IVb) |
Severe cell changes or cancer at an early stage (carcinoma in situ), whereby it cannot be ruled out that the cancer has already invaded surrounding tissue. |
Additional tissue sample to confirm the findings. Further treatment depends on the result. |
|
Pap 5 (V) |
Cancer cells detected. Very high probability that the cancer is no longer limited to the superficial mucosa of the cervix. |
Important: An abnormal finding in the Pap test is not a cancer diagnosis (not even Pap V). For a reliable diagnosis, it is necessary to take tissue from the suspicious areas and examine it in the laboratory.