The Importance of a Pap Test

   The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in gynecology to detect premalignant and malignant (cancerous) processes in the ectocervix. Significant changes can be treated, thus preventing cervical cancer. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.

How the Test is Performed

The Pap smear is done as part of a gynecological exam. You will lie on a table and place your feet in stirrups to position your pelvis for examination. The health care provider will insert an instrument (speculum) into your vagina and open it slightly to see inside the vaginal canal.
The health care provider will take a sample of cells from the outside and just inside the opening of the cervix (cervical canal) by gently scraping the outside of the cervix with a wooden or plastic spatula, then inserting a small brush that looks like a pipe cleaner into the canal.
The cells are placed on a glass slide, or put in a bottle containing a preservative, and then sent to the lab for examination.
Watch Videos:
http://abcnews.go.com/Health/video/pap-smear-12772099
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How to Prepare for the Test

Tell your health care provider if you:

• Are taking any medications or birth control pills
• Have had an abnormal Pap smear
• Might be pregnant

Within 24 hours of the test, avoid:

• Douching
• Having intercourse
• Taking a tub bath
• Using tampons

Avoid scheduling your Pap smear while you have your period (are menstruating), because blood and cells from the uterus may affect the accuracy of the Pap smear. Empty your bladder just before the test.

How the Test Will Feel

You may have some discomfort, similar to menstrual cramps, and a feeling of pressure during the procedure. You may bleed a little bit after the test.

Why the Test is Performed

The Pap smear can detect cancerous or precancerous conditions of the cervix. Most invasive cancers of the cervix can be detected early if women have Pap tests and pelvic examinations.
Screening should start within 3 years after first having vaginal intercourse or by age 21. After the first test:

• Woman should have a Pap smear every 2 years to check for cervical cancer.
• If you are over age 30 or your Pap smears have been negative for 3 times in a row, your doctor may tell you that you only need a Pap smear every 3 years.
• If you or your sexual partner have other new partners, then you should have a Pap smear every 2 years.
• After age 65-70, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.
• If you have a new sexual partner after age 65, you should begin having Pap smear screening again.

Women who have had a total hysterectomy (uterus and cervix removed) and have not had any previous history of cervical dysplasia (abnormal cells), cervical cancer, or any other kind of pelvic cancer, may not need to have Pap smears.

Normal Results

A normal value is negative, meaning there are no abnormal cells present.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

The current system divides the abnormal results into these main areas:

• ASCUS or AGUS (atypical cells of uncertain significance): These changes may be due to infection with HPV but may also mean there are precancerous changes present.
• LSIL (low-grade dysplasia) or HSIL (high-grade dysplasia): This means precancer changes are likely to be present; the risk of cancer is greater if the result is HSIL.
• Carcinoma in situ (CIS): This usually means the abnormal changes are likely to progress to cancer.
• Atypical squamous cells (ASC–H): This means abnormal changes have been found and may be HSIL.
• Atypical glandular cells (AGC): Cell changes are seen that suggest precancer of the upper part of the cervical canal or inside the uterus.

When a Pap smear shows abnormalities, further testing or follow-up is needed. The next step depends on the results of the Pap smear, your previous history of Pap smears, and risk factors you may have for cervical cancer.
This may include:

• Colposcopy-directed biopsy
• An HPV test to check for the presence of the HPV virus types most likely to cause cancer

For minor cell changes, doctors usually recommend having a repeat Pap smear in 3-6 months.

Risks

There are no risks involved.

Considerations

The Pap smear test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Fortunately, cervical cancer develops very slowly in most women and follow-up Pap smears should identify worrisome changes in time for treatment.
The following drugs may affect Pap smears:

• Colchicine
• Compounds in cigarettes
• Estrogen
• Podophyllin
• Progestins
• Silver nitrate

Sources:
http://www.medicinenet.com/pap_smear/article.htm 
http://abcnews.go.com/Health/video/pap-smear-12772099
http://www.cbsnews.com/video/watch/?id=5721042n
Are Pap smears still necessary if I'm 62 years old and have had a hysterectomy?http://www.mayoclinic.com/health/pap-smear/AN00013

2010 Overview in Medical System (IV)

• Updated Pneumococcical Vaccine Guidelines
• National Lung Screening Trial  Halted
• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduces first draft
• Oil Spill In the Gulf 
• First Synthetic Cell 
• New Superbug :NDM-1 
• Genetic Link to ADHD

Updated Pneumococcical Vaccine Guidelines

        The Centers for Disease Control and Prevention in September updated guidelines for use of the 23-valent pneumococcal polysaccharide vaccine in adults. Changes include the recommendation that all persons aged 19 to 64 years with chronic or immunosuppressive medical conditions, including asthma, should receive the vaccine.

National Lung Screening Trial  Halted

The huge randomized National Lung Screening Trial (NLST) in the United States was stopped in November after 8-year results showed that screening heavy smokers with low-dose helical computed tomography (CT) significantly reduced deaths from lung cancer, compared with screening with chest x-rays.

   This was the first time clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled clinical trial has been seen, said Christine Berg, MD, NLST project officer for the Lung Screening Study at the National Cancer Institute, which funded the trial. This finding will "have implications for the screening and management of lung cancer for many years to come," Dr. Berg predicted.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduces first draft

The long-awaited draft of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released by the American Psychiatric Association in February. After a 2-month period of public review and commentary, which garnered "unprecedented" response, standardized field trials began in October. Experts heading up the development of the DSM-5 say the manual is important not only to psychiatry but all medical specialties. One of the primary goals of developing the new manual is to make it more useful in all clinical practice, including primary care, they say.

 Oil Spill In the Gulf

Workers involved in clean-up of the Gulf oil spill may be at risk of being exposed to the volatile organic compounds present in crude oil. Burning oil may result in particulate matter that can be deposited in the lungs, which poses a greater risk to people with underlying health conditions, such as asthma, chronic obstructive pulmonary disease, or heart disease. Psychosocial effects were also important consequences of the Gulf oil spill, according to experts from the Institute of Medicine and the Centers for Disease Control and Prevention.

 First Synthetic Cell

Scientists at the Venter Institute reported the creation of the first "synthetic cell" — Mycoplasma capricolum cells that received and are controlled by a laboratory-assembled genome of Mycoplasma mycoides.

New Superbug :NDM-1

NDM, a gene that makes bacteria impervious to many antibiotics, is spreading worldwide. The gene evolved in India but is widespread in Pakistan and Bangladesh as well. It's been isolated all across the United Kingdom, prompting a national alert. It's also popped up in the United States, Canada, Sweden, Australia, and the Netherlands. A Swedish patient of Indian origin who got a urinary tract infection while visiting New Delhi was found to be infected with NDM-carrying bacteria. Reseachers dubbed the new bug NDM-1.

Nobel Prize Awarded to In Vitro Fertilization Developer

Robert Edwards, PhD, was awarded the 2010 Nobel Prize in medicine or physiology, for his work in developing  in vitro fertilization (IVF). About 4 million people were born over the past 32 years using IVF.

Genetic Link to ADHD

New research provides the first direct evidence that attention-deficit/hyperactivity disorder (ADHD) is genetic. In a study published online September 30 in The Lancet, investigators from the University of Cardiff, United Kingdom, say their findings suggest ADHD should be classified as a neurodevelopmental and not a behavioral disorder.