A pap smear only screens for cervical cancer and pre-cancerous cervical changes called dysplasia. It does not test for anything else - STDs, ovarian cancer, uterine cancer, any benign changes of the female genital tract.
During an exam, providers sometimes do other tests - like testing for STDs, or an exam to feel the size of the ovaries and uterus, but there is no standard exam that every provider will be doing, so you'd want to ask what else they are doing.
Pap smears are screening tests, not diagnostic tests. Most screening tests are designed to be overly sensitive. That is, you want the test to hopefully pick up as many people as possible that have the disease, so you accept some false positives in exchange for not having many false negatives. So, if a pap is abnormal, usually other testing is recommended, often colposcopy. colposcopy is a test where the provider looks at the cervix under magnification and paints the cervix with vinegar which makes abnormal cells more apparent. If abnormal areas are seen, they can then be biopsied, which is diagnositic (not a screening test - the biopsy gives a definite diagnosis.)
Almost all cervical cancers and pre-cancerous changes are caused by HPV. HPV in one strain or another is carried by 80% of the adult population, but the majority of those folks do not, of course, get cervical cancer. For most people, HPV is a short lived infection that the body naturally fights off. For some, certain strains (70% of cervical cancer is linked to 2 particular strains) cause pre-cancerous cervical cell changes which can eventually lead to cervical cancer. 11,000 new cases were found in the US in 2007, and there were 3670 deaths according to the National Cancer Institute - whichi s a huge decrease since pap smear screening started when cervical cancer was among the leading causes of cancer death in women. Cervical cancer is very curable when caught early, and when the most severe type of pre-cancerous changes are found (severe dysplasia) there are treatments that spare fertility. The majority of new cases of invasive or advanced cervical cancer occur in women who have not had pap screening in the last 5 years.
There are several current recommendations on how often pap screening should occur. Most now say something along the lines of starting pap screening at age 21 or within 3 years of becoming sexually active, whichever comes first, pap screening every 1 year from age 21-29, or every 2 years with liquid based paps, and every 2-3 years thereafter until age 65, when pap screening can stop if there is no history of cancer and no change in sexual partner.
Keep in mind that the guidelines are taking into account the chance that a woman will encounter HPV in her lifetime. If you have no change in partner and no history of HPV or abnormal pap smears after 3 years, your chance of getting cervical cancer is practically zero. That is something an individual woman can use in making her decision on pap screening, but as a health care provider I continue to offer paps based on guidelines (I don't have an accurate way of knowing that every woman I see is truthful or wants to share her sexual history, and I especially have no way of knowing her partner(s) sexual history.) Therefore, I offer based on the current guidelines, with the above explanation, but I'm not a fan of refusing other care, like birth control, or whatever, if the woman declines pap testing.
: Which wouldn't be that big of a deal if there WERE other decent providers in my area. Sigh..
Ds was/is just fine TYVM. I wanted to enjoy my pregnancy, not stress over waiting for test results and risking false positives.
