Welcome to Ask a Doctor! Every week we’ll be asking our CarePoint Health doctors some questions that we’d all like to know the answers to.
This week we have a return guest, Doctor Osbert Fernandez MD, FACOG, FAAFP. He’s one of our OBGYN specialists in Hoboken with an interest in high risk obstetrics and minimally invasive gynecological surgery. This week he’s answering our questions about Pap smears.
Q: What is a Pap smear?
A: The Pap smear is a test used to screen women for precancerous or cancerous
lesions of the cervix. The purpose of the test is to identify women with early
stages of cervical disease. If the disease is identified early, appropriate
treatments can be applied and cervical cancer can be avoided.
Q: How is a Pap smear performed?
A: The Pap smear is one component of the gynecological exam. A speculum is
inserted into the vagina, the cervix is visualized with a light source and the cells
from the cervix are sampled using a medical brush. The specimen is then sent to
a pathologist for evaluation.
Q: Do all women need to get a Pap smear? If so, how often?
A: In the United States, cervical cancer screening is usually recommended at
21 years of age and if the results are normal, screening should occur every
3 years. For women 65 years and older who have a history of normal Pap
smears, screening may stop. If at any age the Pap smear is abnormal, screening
may need to occur more frequently, perhaps yearly or as your doctor deems
necessary. If the patient has had a hysterectomy (removal of uterus and
cervix) they do not need a Pap smear unless the cervix was removed due to a
cancerous condition, the surgery was subtotal and the cervix was left behind, or
the patient was exposed to diethylstilbestrol while in utero. If you have a history
of HIV or if your immune system is compromised, you may need to be screened
more frequently. I would also like to stress that the while Pap smear, if normal,
should be done every three years, a gynecological exam should be performed
yearly. If you have any questions you should consult your physician.
Q: What information about my health can be learned from a pap smear?
A: The results of the Pap smear are usually reported by the pathologist. The
reports can come back ranging from normal, atypical, low grade, high grade,
precancerous to cancerous lesions. The treatment and follow up depends on the
Q: If I receive an abnormal result, what is the next step?
A: If your results are normal, the follow up should be routine. If abnormalities
have been identified, further evaluation is necessary. The first step in the
evaluation is a colposcopy. This exam allows your doctor to look at the cervix
with a microscope and try to identify the area of the cervix that is responsible for
the abnormal cells collected at the time of the Pap smear. If abnormal areas are
identified, biopsies may be obtained. If the colposcopy changes the diagnosis,
other testing such as a LEEP procedure may be needed.
Osbert Fernandez, MD, FACOG, FAAFP is a graduate of St. George’s University
School of Medicine. He completed his Obstetrics and Gynecology residency at
St. Vincent’s Hospital and Medical Center in New York City where he served
as Chief Resident in 2003. He is dual board certified in Family Practice and
Obstetrics and Gynecology. Dr. Fernandez is an Attending Physician with
CarePoint Medical Group, serves as Associate Director of the Department of
Obstetrics and Gynecology at Hoboken University Medical Center and is an
Assistant Clinical Professor at New York Medical College in the Department of
Dr. Fernandez has special interest in high risk obstetrics and minimally invasive
gynecological surgery. He is certified by the North American Menopause Society
(NAMS) for his commitment to menopausal health. He is currently the Principal
Investigator for the Violet Petal Study a phase 3 clinical trial for the treatment
of severe endometriosis. He has won various teaching awards, and in 2003 he
was awarded a Humanitarian Award for his dedication to women’s health. Dr
Fernandez is fluent in Spanish.