Ask A Doctor: Pap Smear

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.



Osbert Fernandez MD, FACOG, FAAFP



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

results obtained.


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

Family Medicine.


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.


Please visit our website to read Dr. Fernandez’s profile and take a minute to check out our page on Women and Children’s Health.


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