What is Pap smear?
A Pap smear is a simple test to check your cervix to make sure it is healthy. Your cervix is the opening of the womb. The Pap test (or Pap smear) looks for precancerous cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
Why are cervical screening tests advised?
Cervical cancer is a disease that can often be prevented. Early changes can be detected in the neck of the womb (cervix), which indicate that cancer may develop. It usually takes 3–7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Since screening started, the numbers of cases of cervical cancer have dramatically dropped. It is one of the few types of cancer which can be detected and stopped before it ever begins.
What causes cervical cancer?
An infection with a virus called HPV (human papillomavirus) is the cause of almost all cervical cancers. There are more than 100 different types of HPV. Two of these types are known to cause most of cervical cancer. HPV is very common. Most people (four out of five) will have HPV at some time in their lives. Anyone who has ever had sex can have HPV. In most cases, HPV clears up by itself in a few years. This means that most women who are infected with HPV do not develop cancer. Sometimes the virus can stay in your body longer and can lead to cervical cancer. This usually takes a long time.
How is Pap smear done?
During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal. If the test shows any abnormality, you will have treatment to stop you ever getting cancer of the cervix. So, an abnormal test does not mean you have cancer. It means you should have some treatment to stop you getting cancer. Cervical screening tests are not painful, although some women find the speculum uncomfortable. It generally helps if you can relax – this makes the experience better for you and easier for the person taking the sample.
When does Pap smear need to be done?
The screening guidelines vary from country to country. In general, the Pap test is recommended for all the women about the age of 21 – 25 years and continuous until the age of 65 years. It can be done in a doctor’s clinic. Screening is typically recommended every 3 to 5 years as long as the results are normal.
Pap smear screening is also recommended for those who have been vaccinated against HPV. As the vaccines don’t cover all types of HPV and the vaccine does not protect against HPV exposure before vaccination.
Only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor find out why you’re having them. If your Pap test results are normal, your doctor may tell you that you can wait three years until your next Pap test.
What do the results of the cervical screening test mean?
In most women, the cells that are taken are found to be normal. Abnormal cells are found in some women. An abnormal result does not mean cancer in the vast majority of cases. Abnormal cells indicate that cancer may develop sometime in the future. About 6 women in 100 will have an abnormal result that requires further testing or treatment.The results are reported as one of the following:
- Normal.
- Inadequate.
- Abnormal – of which there are several grades or degrees of abnormalities from low grade to high grade.
- Possible cancer cells: invasive or glandular neoplasia.
Most of these changes will not lead to cervical cancer. Treatment can be given to prevent cancer from developing in women with abnormal cells. Depending on your test results, your health care provider may recommend:
Routine follow-up testing. Depending on your age and tests received, this may be every 3-5 years.
Follow-up testing with a Pap test and an HPV test.
Colposcopy and cervical biopsy
Like a lot of medical testing, it’s not very pleasant to do a pap smear but the brief discomfort isn’t a good reason to neglect your wellbeing. Getting regular pap smear is the best way to protect your health from cervical cancer.
Dr.Usha Sethi
Specialist Gynaecologist
Aster Clinic, Tecom (Barsha Heights)
