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PAP Smear Test

Cervical PAP Smear Test

A Pap smear test, also known as a Pap test, is a method to conduct test for cervical cancer among women.

This test involves getting cells collected from the cervix —lower, narrow end of uterus that is at the top of vagina.

Cervical cancer can be detected at an early stage with a Pap smear test that provides better chance for cure. With a Pap smear, you may also detect dome changes in the cervical cells that usually suggest cancer to develop in future. By detecting these abnormal cells early through Pap smear, you can prevent cervical cancer from developing further.

About cervical cancer

Cervical cancer develops in the cervix of a woman which is the entrance to their womb from vagina.

Cancer of the cervix usually does not show any symptoms at the early stages. If you detect some symptoms, then the most common is abnormal vaginal bleeding that may occur after having sex, in between your periods or after menopause.

Cervical cancer is the result of some change in cell DNA that takes place due to human papilloma virus or HPV in almost all cases.

Cancer starts with a change in the DNA’s structure present in all human cells. DNA offers cells with certain instructions like when to grow and reproduce.
Regular cervical screening is the suitable option to detect abnormal changes in the cells of cervix early.

Women who fall in the age group of 25-49 years are invited to get screening done in every three years. Women within the age group of 50-64 years are invited to go for screenings in every five years. Women who are 65 years or more and those who have not undergone screening tests since they had turned 50 might be asked to go for the test.

Make sure your gp has your contact details so that you may continue getting screening invitations from time to time.

It is important you go for cervical screening tests even though you are already vaccinated for HPV. This is mainly because the vaccine will not provide any guarantee for the protection of cervical cancer.

If you have already been treated for changes in abnormal cervical cell, then you will be invited for screening often for several years after the treatment is done. How frequently you might go will depend on how severe your cell chances are?

Abnormal bleeding does not mean in any way that you have cervical cancer, but your gp will check your health condition soon. If he thinks you have cervical cancer, then you might be referred to a specialist within two weeks.

Why you need to undergo pap smear test

A Pap smear is used to get screening done for cervical cancer.

Pap smear is usually done together with a pelvic examination. Women who are above 30 years, this Pap test might be combined together with a test for human papillomavirus or HPV which is a sexually transmitted infection that may lead to cervical cancer. There are certain cases when HPV test might be done than a Pap smear.

Who Needs A Cervical Smear Test?

PAP Test

The PAP smear test is recommended by the NHS for every woman from the ages of 25 - 64. This is because, within these age range, abnormal cells are more likely to be noticed easily. For women below the age of 25, abnormal cells are more likely to go away on their own, even without medical intervention. Also, it is less likely for these abnormalities in the cells to develop into cervical cancer for women below 25 years of age.

On the other hand, women above 64 years of age do not have abnormalities in their cells anymore. If they were not detected between 25 - 64, as they grow older, the cells would have fully developed into cancerous cells. At the recommended ages of 25 - 64, the abnormal cells will be identified (if any), and the necessary treatment to prevent cervical cancer and other dangerous diseases will commence.

How often should you perform a Pap smear test?

Doctors usually suggest repeating Pap testing in every three years for women in the age group of 21 to 65.

Women who are 30 and above might consider Pap testing in every five years if the method has been combined with HPV testing. They might even consider HPV testing than Pap test.

If you have certain risk factors, your doctor might suggest Pap smears more frequently, despite your age. Certain risk factors consist of the following:

  • Proper diagnosis of a cervical cancer or a Pap smear showing precancerous cells
  • Exposure to diethylstilbestrol (DES) before your birth
  • HIV infection
  • Weak immune system due to chemotherapy, chronic corticosteroid use or organ transplant
  • Smoking history

Both you and your doctor may discuss the benefits and risks associated with Pap smears before deciding what will be the best for you based on various factors.

Benefits of A Smear Test

  • It detects abnormalities in cells, which if ignored, can lead to cervical cancer
  • It is very useful in detecting and preventing cancer
  • It also helps in detecting changes that indicate other possible diseases like HPV

Vices of A Smear Test

  • Possibility of a false negative result. This is a situation whereby abnormal cells are not noticed by the examiner, after a PAP smear test. Because of this, the results are deemed negative, and the abnormal cells continue to grow. It could be as a result of failure on the part of the examiner, or equipment or tool error.
  • Possibility of a false-positive result.This is a situation whereby abnormal cells are noticed after a PAP test. However they may not turn out to be cancerous in future. As a result, the patient undergoes treatment that she does not need.

How to prepare yourself for Pap smear test

If you want to know if your Pap smear is effective, follow these effective tips before performing the test:

  • Avoid douching, intercourse, using spermicidal foams, jellies, creams or any vaginal medicines for two days before a Pap smear as these can wash away or obscure abnormal cells.
  • Do not schedule a Pap smear during the menstrual period as it is best to prevent at this time of your cycle.

About pap smear procedure

Pap Smear Test

A Pap smear can be done at the doctor's office that requires only a few minutes. You might be asked to undress yourself completely or from the waist down only.

You need to lie down at the back on an examination table with knees almost bent. In this situation, the heels rest in support known as stirrups.

Your doctor will be inserting an instrument known as a speculum gently into the vagina. This speculum will hold your vagina walls apart so that the doctor can see the cervix easily. Inserting the speculum might lead to a sensation of pressure in the pelvic area.

Your doctor takes samples of the cervical cells with a soft brush and a flat scraping device known as a spatula which usually does not hurt.

Pap smear after care

Once the Pap smear test is done, you can go throughout the day without any restrictions.

Depending on the kind of Pap testing you need to undergo, your doctor transfer cell samples collected from the cervix to a special liquid container that preserve the sample or on a glass slide.

The samples are then sent to the laboratory where they will be examined under a microscope for detecting cells characteristics that denote cancer or precancerous condition.

You may ask your doctor when to expect the test results.

Results

A Pap smear will alert the doctor about the presence of suspicious cells that may require further testing.

Normal results

If cervical cells had been discovered during the Pap smear, you will get negative results. But, you will not require further testing or treatment till you are left for the next Pap smear and pelvic examination.

Abnormal results

If unusual cells were identified during the Pap smear, you will get positive results which mean you are having cervical cancer. The result depends on the kind of cells already found in the test.

Go through some terms used by the doctor and about your next course of action:

  • ASCUS or Atypical squamous cells of undetermined significance – Squamous cells are flat and thin that usually grow on the surface of a cervix. For ASCUS, the Pap smear denotes slightly unusual squamous cells, however the changes do not suggest clearly that precancerous cells are there.
    By performing liquid-based test, the doctor may reanalyze samples to detect the presence of viruses for promoting the development of cancer like some kinds of human papillomavirus (HPV).
    If there aren’t any high-risk viruses, the abnormal cells found due to the test won’t be of much concern. However, if the viruses are present, then you will require undergoing further testing.
  • Squamous intraepithelial lesion – It can be used to detect that the cells collected from Pap smear might be precancerous.
    If the changes are of low grade, then this means the shape, size and other cell characteristics that suggest if a precancerous lesion is present, it is quite possible to be some years away from detecting a cancer.
    On the other hand, if the changes are of higher grade, there is a chance that the lesion might turn into cancer soon. Besides, additional diagnostic testing might be needed.
  • Atypical glandular cells – These glandular cells grow into the opening of cervix and within the uterus and produce mucus. Atypical glandular cells might be slightly abnormal though it not evident if they are cancerous.
    Further testing might be required to know the source of abnormal cells and their significance.
  • Adenocarcinoma cells or squamous cell cancer – This means the cells collected for Pap smear seem abnormal and the pathologist is certain you have cancer.
    "Squamous cell cancer" denotes cancers that may arise in the flat surface cells of your cervix or vagina. "Adenocarcinoma" refers to those cancers that occur in glandular cells. In case such cells have been found, then your doctor might suggest quick evaluation.

If the Pap smear is unusual, then your doctor might perform a procedure known as a colposcopy. For this, a special magnifying instrument or colposcope might be used that helps to examine the tissues of vagina, vulva and cervix.

Your doctor might be taking a tissue sample or biopsy from any areas that seem to be abnormal. The tissue sample will then be sent to the laboratory for thorough analysis and ultimate diagnosis.

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