What is a Pap smear?
A Pap smear test, also known as Pap test, is a diagnostic procedure for cervical cancer in women. It checks for the presence of pre-cancerous or cancerous cells in the cervix, which is the opening of the uterus.
During a Pap smear procedure, cells from the cervix are gently scraped and observed for abnormal growth. A Pap smear procedure may be mildly uncomfortable but usually doesn’t cause any long-term pain.
A Pap smear procedure also detects changes in the cervical cells, which suggests possible development of cancer in the future.
What does a Pap smear test for?
A Pap smear procedure is used to diagnose cervical cancer. It is usually done alongside a pelvic exam. For women above 30 years, the Pap test should be done in combination with a test for human papillomavirus (HPV), which is a common sexually transmitted infection that can cause cervical cancer. In some cases, the HPV test alone may be done.
The current guidelines recommend for women to get regular Pap tests every three years once they clock 21. Also, those who are
- HIV positive, and/or
- Have a weakened immune system owing to chemotherapy or an organ transplant.
Should get tested more frequently.
Preparation for a Pap smear test.
To ensure a most effective Pap test, it is important to:
- Stay away from intercourse, douching, or usage of any vaginal medicines and/or spermicidal foams, creams or jellies for two days before going for a Pap test, as these are likely to wash away or obscure abnormal cells.
- Not schedule a Pap test in a menstrual period.
Pap smear procedure.
A Pap smear procedure may be a bit uncomfortable, but it’s usually very quick. There are about four main steps.
- The first step during a Pap smear procedure is to lie flat on the back on an examination table with the legs spread and the feet placed on supports, known as stirrups.
- The doctor will then slowly and gently inserts a device, known as a speculum, into the vagina. A speculum keeps the vaginal walls open and gives access to the cervix. The insertion of the speculum may likely cause a sensation of pressure in the pelvic area. Small cell samples are then scraped from the cervix. This can be done using:
- A tool is known as a spatula.
- A spatula and a brush.
- A device is known as cytobrush, a combination of spatula and brush.
- The cell sample collected from the cervix is preserved and sent to the lab for testing and detection of the presence of abnormal cells.
The aftermath of a Pap smear procedure.
After a Pap test, there might be mild discomfort or slight cramping from the scraping. There’s also likely to be light vaginal bleeding immediately after a test. If this continues after the day of the test, a formal complaint should be logged to the doctor.
Pap smear test results.
There are two probable results from a Pap smear test: normal (or negative) or abnormal (or positive).
- Normal Pap smear : If the results of a Pap test are normal, this means no abnormal cells were identified. This is the case in most pap tests.
- Abnormal Pap smear : However, if the Pap test results are abnormal, this doesn’t mean cancer has been diagnosed. This simply means abnormal cells were seen on the cervix, of which some could be pre-cancerous. Also, it should be noted that there are several levels of abnormal cells, such as atypia, mild, moderate, severe dysplasia and carcinoma in situ.
Depending on the extent of the cell changes shown by the test results, more tests may be recommended straight away or after 6 months. These include:
- An increase in the frequency of Pap smear tests.
- Colposcopy, a procedure that helps get a closer look at your cervical tissue.
Does Pap smear test for HPV?
The sole aim of a Pap smear test is to ascertain cellular changes in the cervix. These changes could be caused by an HPV. Also, it’s possible to test for an HPV from a Pap smear specimen.
A Pap test, however, doesn’t detect other sexually transmitted infections (STIs).
Who should have a Pap smear?
In general, it is recommended that anyone above the age of 21 should start carrying out Pap smear routinely.
How often should a Pap smear be repeated?
Generally, Pap smear procedure is recommended for every three years, for women between the ages of 21 to 65.
For women who are 30 years and older, they can consider carrying out Pap test every five years if the procedure is combined with HPV testing.
Who can consider stopping a Pap smear?
In certain circumstances Pap testing may no longer be necessary. These circumstances are:
- After a total hysterectomy (that is, surgical removal of the uterus including the cervix)
- Old age – Generally it is agreed that women can consider stopping routine Pap smear testing at the age of 65 if previous tests for cervical cancer have been negative.
What is cervical cancer?
Cervical cancer is a form of cancer which develops in the cells of the cervix, the lower part of the uterus. Small and narrow, it connects the uterus and the vagina. It offers an entry for sperm to get into the uterus. It also serves as an exit from the uterus for monthly blood flow or for babies during delivery.
How accurate are the results?
Pap smears are very accurate. Regular Pap smear screenings help reduce the rates and mortality of cervical cancer by at least 80.