Women are typically advised to have a Papanicolaou test — otherwise known as a Pap smear — at least once every few years, because this medical exam checks for abnormalities of the cervix. When the results of this screening test show abnormal cells that could indicate cervical cancer or vaginal infection, many doctors order a colposcopy. This is a diagnostic test that allows doctors to get a closer look at the cervix before determining the cause of the abnormal cells. Thus, the main connection between a Pap smear and colposcopy is that both are used in making a diagnosis regarding cervical abnormalities.
During a Pap smear, a doctor inserts a speculum into the patient's vagina so the cervix is visible. The cervix is then swabbed so cells can be collected and sent to a laboratory, where the cells are examined closely using a microscope. This means the results of a Pap smear usually take a few weeks to be sent back to the doctor, who then lets the patient know if abnormal cells are discovered. One of the main differences between a Pap smear and colposcopy is that the Pap test is only used to screen, while the colposcopy can be used to make a diagnosis or call for more testing. Therefore, both a Pap smear and colposcopy are typically necessary to conclusively determine the issue.
Colposcopy is typically just as short and painless as a Pap smear, though some doctors may perform procedures during the test that cause discomfort. During the exam, the doctor applies an acetic acid to the cervix to make abnormal cells easy to spot. The next step is to place a colposcope, which is an electric microscope, in front of the vagina so the cervix can be viewed. During this diagnostic medical exam, the doctor focuses on the white spots of the cervix, because these areas indicate abnormal cells. In some cases, the Pap smear and colposcopy both show that nothing is wrong, in which case the doctor will not see any abnormal cells during testing.
If the colposcopy shows there are abnormal cells, many doctors opt to perform a biopsy to get a tissue sample for additional testing. This may feel like a pinch and tends to cause mild abdominal cramps and light bleeding afterward. The tissue collected during the biopsy is sent to a lab for a pathologist to examine. In some cases, the results show evidence of cervical cancer, at which time more testing is usually required before treatment is started. Most cases never make it to the biopsy stage, because both the Pap smear and colposcopy indicate milder issues, such as a vaginal infection, inflammation or human papillomavirus (HPV).