A Pap smear is a screening test for cancer. However, the vast majority of abnormal Pap smears are not due to cancer. Some abnormalities are due to inflammation or inadequate numbers of cells, and may be managed simply by repeating the Pap smear after treatment of the cause of the inflammation. Pap smears showing atypical or precancerous cells are best evaluated by a procedure called colposcopy. During this procedure, the doctor examines the cervix, vagina, and vulva using magnification. Areas of abnormality are sampled with a biopsy and a treatment plan is recommended. Many minor abnormalities are observed by means of frequent Pap smear combined with periodic colposcopy. Some abnormalities are treated using electrical excision, known as LEEP, an office procedure. If cancer cannot be ruled out by means of colposcopy, then a more extensive biopsy of the cervix called a conization needs to be performed.
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