Cervical Pap Smear

Introduction

• Screening test
  • can detect squamous dysplasia and cancer
  • can evaluate patient’s sex hormones
    • superficial squamous cells
      • indicates full mucosal surface maturation and therefore the presence of estrogen
      • high estrogen without progesterone results in 100% superficial squamous cells
    • intermediate squamous cells
      • indicates presence of progesterone
      • high progesterone in pregnancy results in 100% intermediate cells
    • parabasal cells
      • indicates lack of estrogen and progesterone
      • seen in elderly women
• Process
  • must sample transition zone between endo (columnar) and exo (squamous) cervix 
  • smear must show presence of columnar cells to prove that transition zone was reached