Editing Pap test (section)

===Types of screening===
{{for|other cervical screening tests and human papillomavirus testing|Cervical screening}}
* Conventional Pap—In a conventional Pap smear, samples are smeared directly onto a microscope slide after collection.
* Liquid-based cytology—The sample of (epithelial) cells is taken from the transitional zone, the squamocolumnar junction of the cervix, between the ectocervix and the endocervix. The cells taken are suspended in a bottle of preservative for transport to the laboratory, where they are analyzed using Pap stains.
[[File:Transformation zone types.png|thumb|240px|Transformation zone types, determining the Pap test location:<ref>International Federation for Cervical Pathology and Colposcopy (IFCPC) classification. References:<br>-{{cite web|url=https://www.rcpa.edu.au/Library/Practising-Pathology/Structured-Pathology-Reporting-of-Cancer/Docs/Transformation_zone|title=Transformation zone (TZ) and cervical excision types|website=[[:en:Royal College of Pathologists of Australasia|Royal College of Pathologists of Australasia]]}}<br>- {{cite journal|last1=Jordan|first1=J.|last2=Arbyn|first2=M.|last3=Martin-Hirsch|first3=P.|last4=Schenck|first4=U.|last5=Baldauf|first5=J-J.|last6=Da Silva|first6=D.|last7=Anttila|first7=A.|last8=Nieminen|first8=P.|last9=Prendiville|first9=W.|title=European guidelines for quality assurance in cervical cancer screening: recommendations for clinical management of abnormal cervical cytology, part 1|journal=Cytopathology|volume=19|issue=6|year=2008|pages=342–354|issn=0956-5507|doi=10.1111/j.1365-2303.2008.00623.x|pmid=19040546|s2cid=16462929|doi-access=free}}</ref><br>Type 1: Completely ectocervical.<br>Type 2: Endocervical component but fully visible.<br>Type 3: Endocervical component, not fully visible.]]
[[Image:Gray1167.svg|thumb|Cervix in relation to upper part of vagina and posterior portion of uterus.]]
[[File:Cytology of cervical squamous metaplasia.png|thumb|220px|Squamous metaplasia of the cervix, with typical features. Pap stain.]]

Pap tests commonly examine epithelial abnormalities, such as metaplasia, dysplasia, or borderline changes, all of which may be indicative of CIN. Nuclei will stain dark blue, squamous cells will stain green and keratinised cells will stain pink/ orange. Koilocytes may be observed where there is some dyskaryosis (of epithelium). The nucleus in koilocytes is typically irregular, indicating possible cause for concern; requiring further confirmatory screens and tests.

In addition, human papillomavirus (HPV) test may be performed either as indicated for abnormal Pap results, or in some cases, dual testing is done, where both a Pap smear and an HPV test are done at the same time (also called Pap co-testing).<ref>{{Cite journal |last1=Zhang |first1=Salina |last2=McNamara |first2=Megan |last3=Batur |first3=Pelin |date=June 2018 |title=Cervical Cancer Screening: What's New? Updates for the Busy Clinician |url=https://linkinghub.elsevier.com/retrieve/pii/S0002934318300950 |journal=The American Journal of Medicine |language=en |volume=131 |issue=6 |pages=702.e1–702.e5 |doi=10.1016/j.amjmed.2018.01.020|pmid=29408216 |s2cid=46780821 }}</ref>