About 50 million Pap smears are performed annually in the United States. At Washington Women's Care over 6,000 Pap smears are performed each year. Some patients may recall the old classification of Pap smears, "classes", but all Pap smears today are evaluated based on the Bethesda system. Basically, standard Pap smear sampling with the spatula and brush has gone by the wayside. Thin layer technology is now used, obtaining a sample with a single brush, sampling of the endocervix and ectocervix. This method is safe for use in pregnancy. The brush is transported in a liquid medium, with the contents then spun down in the lab, allowing a pellet of cells to be evaluated. Extraneous material and red blood cells are therefore eliminated. The slide is then prepared and examined under a microscope. The liquid media can be saved, making the sample available for human papilloma virus testing for certain patients if indicated. Thin layer technology has been found to decrease false positive findings, as well as increase the rate of detection of glandular abnormalities of the endocervix.

ACOG recommendations regarding Pap smears have changed in the recent past. A woman should undergo her initial Pap smear within 3 years of becoming sexually active. Pap smears should be performed yearly all in high risk women, which includes those beginning intercourse at an early age, having had multiple partners, or any history of a sexually transmitted disease. Following hysterectomy, unless the patient is known to be high-risk, Pap smears of the vaginal apex should be performed about every 2-3 years until after age 65. If the results are negative, Pap smears can potentially be discontinued at that time.

If you have any questions about appropriate Pap smear intervals for you, please discuss this with your healthcare professional, or the professionals at Washington Women's Care.

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