Pap smears are screening tests for cervical cancer, or precursors of cervical cancers, and are taken from the area where cells are changing. This is called the transformation zone, and all women have one.
A spatula is scraped around the outside of the cervical canal and a brush is used to scrape the cervical canal. Doing a Pap from these two areas will gather cells from most women’s transformation zone. These two specimens make up a Pap smear and are put together into a liquid media (Thin Prep), or can be placed on a glass slide and sprayed with a fixative. Liquid media has replaced the conventional glass slide Pap in most parts of the U.S., and is considered more accurate. Ask your health care provider to see which you are getting.
DES Daughters also should have the brush for inside the cervical canal and the spatula for around the outside of the cervix, but a vaginal smear should also be taken. That same spatula is scraped along the entire upper vagina walls and is called a 4-quadrant vaginal smear. Many women have asked if this 4-quadrant smear should be put into a separate bottle or slide. Short answer is NO – pathologists feel this in unnecessary – put all the specimens in the same bottle.
The cytopathologist will be looking to see that there are normal squamous cells, normal glandular cells and cells undergoing squamous metaplasia (normal cell changing that occurs in all women). These cells let the cytopathologist know that the transformation zone was sampled. Of course, he or she also is looking for any abnormal glandular or squamous cells that would signal possible cancers or precursors of cancer.
A Pap smear is only one part of the proper Pap/pelvic exam needed every year by DES Daughters. Print directions for the DES Daughter Annual Exam to share with your health care provider.