When is the best time in your cycle to have a Pap smear? Could timing have a bearing on atypical cells being found? Should you refrain from intercourse before the test? Are there other factors that can make the test less accurate?

--Shelly

The best time to have a Pap smear done is midcycle -- about two weeks after your period begins, in most cases. If a Pap is done while there is still blood present or if there is an infection, it may be more difficult to interpret, and the lab may be more likely to call the results atypical. Ideally, for 24-48 hours before the Pap, you should refrain from intercourse and avoid douching and using any vaginal creams, ointments, etc.

Two new technologies, called PAPNET and ThinPrep, can increase the accuracy of Pap reports. PapNet involves doing a traditional Pap (using a swab to sample cells from the outer and inner cervix, smearing the samples on a slide and then spraying the slide with a fixative) -- but instead of just a human technician examining the slide under a microscope, a computer examines it too. The computer is programmed to recognize abnormal cells; it may pick up smaller or more subtle abnormalities that may be overlooked by the human eye.

ThinPrep is a modification of the entire Pap technique. Swabs are taken as usual, but instead of being smeared on a slide, they are swirled in a vial of preservative; this is then filtered and an even layer is spread on a slide, which then may be examined by a technician or even go through the PapNet computer. The ThinPrep keeps the cells from clumping, which can obscure details. It also reduces the number of diagnoses of "atypical squamous cells of undetermined significance" because it filters out inflammatory cells (from infection) and blood. Ask your doctor about the availability of these tests -- they are more expensive than a regular Pap and may not be covered by all insurance plans.