Diagnostic tests are usually biopsies. In the vast majority of instances, an abnormal Pap test results in the diagnosis of a minor change on the cervix. Some of these changes will be premalignant, but most will be of minor significance. They will all have to be evaluated, diagnosed and treated, but most will be easily and effectively treated. Occasionally, a real cancer will be present which is why this is such an important test.
Most cancers are visible on examination and can be biopsied as soon as they are seen.
Sometimes the cancers are inside the cervix beyond view and the only indication that it is there is the abnormal Pap test. Pap test screening is recommended for all women beginning at age 18 years or at the onset of sexual activity, if earlier. The screening interval is usually every year, although, if there have been no previous abnormal tests, the interval may be extended. The Pap test is performed by gently scraping cells from the cervix, smearing them onto a microscope slide and sending it to a pathology laboratory for evaluation. There are two reporting systems in current use.