Why is Pap Smear Test Important for Females?

Pap Smear Test in Kathmandu, Nepal | Clinic One

For an appointment with a Gynecologist, please call Clinic One at 01-5400400/ 9863393960.

What is the Pap Smear Test?

Pap Smear Test / Papanicolaou test is a procedure used to test for cervical cancer in women.

It is the method of cervical screening used to detect potentially precancerous & cancerous processes in the cervix by exfoliating cells from the cervix and analyzing them microscopically.

Cervical cancer is the 4th most common cancer in women globally, and 13.3 women out of 100,000 died of cervical cancer in 2020. About 90% of deaths due to cervical cancer occur in low and middle-income countries (Cervical Cancer, n.d.). 

In Nepal, cervical cancer ranks 1st as the most commonly found cancer in women. According to Nepal Human Papillomavirus and Related Cancers, Fact Sheet 2023, about 2244 women have been diagnosed with cervical cancer every year, with 1493 deaths (“Nepal: Human Papillomavirus and Related Cancers, Fact Sheet 2023,” 2023),

Fortunately, the incidence of cervical cancer has decreased by 50% in the past 30 years largely due to the increasing use of cervical cancer screening and HPV Vaccine. The mainstay of cervical cancer screening has been Pap Smear Test.

During the Pap Smear Test, the collected cells are released into a vial of liquid preservative that is used in a laboratory to produce a slide for microscopic evaluation of cells.

Pap smear remains an effective and widely used method for early detection of precancerous & cervical cancer. It may also detect infections and other abnormalities.

Who should have a Pap Smear Test and How Often?

In general, doctors recommend the beginning of Pap smear testing at the age of 21 and going up to 65 years – testing every 3 to 5 years during the ages when females are sexually active.

However, in many countries, a Pap smear is not recommended for non-sexually active females since about 99% of cervical cancers are attributed to infection from the Human Papilloma Virus (HPV), which is transmitted sexually.

Furthermore, if the result of the Pap smear is abnormal, depending on the nature of the abnormality, the test may need to be repeated every 6 to 12 months.

If you have certain risk factors, which are mentioned below, regardless of age, you need Pap smear test more frequently.

• Diagnosis of cervical cancer or a pap smear showed precancerous cells.
• HIV infection
• Weakened Immune system due to organ transplant, chemotherapy, or chronic corticosteroid use.

Pap Smear Screening is still recommended for those who have been vaccinated against HPV since the vaccine does not cover all of the HPV types that can cause cervical cancer. Also, the vaccine does not protect against HPV exposure before vaccination.

If you had a hysterectomy (surgical removal of the uterus) because of abnormal cancerous cells or cervical cancer, you should continue to have a Pap Smear. If the uterus is removed but the cervix is still there, then a regular Pap smear is needed until the age of 65.

For whom are Pap Smear Test not recommended?

• Never had sexual contact.
• Under the age of 21, regardless of sexual history.
• Over the age of 65, if the previous tests of the cervical test have been negative.
• Have had surgical removal of uterus along with cervix for reasons other than abnormal cervical cancer.

How can you prepare for Pap Smear Test?

• Avoid intercourse – using any vaginal medicine, spermicides form cream/jellies 2 days before having a pap smear.
• Don’t schedule Pap smear during your menstrual period.
• Empty bladder before Pap smear.

What can you expect during Pap smear?

Pap smear is performed in the doctor’s office and takes only a few minutes.

You may be asked to undress from your waist down and lie down on your back on the examination table with your knees bent.

Then the doctor will insert a vaginal speculum that holds the walls of the vagina apart. A soft brush and flat scraping device called a spatula are inserted into the vagina to obtain a sample of cervical cells.

The samples are then transferred into a container holding a special liquid to study under the microscope to look for characteristics in cells that indicate cancer or precancerous conditions.

What does the result of your Pap Smear Test mean?

Normal 

If only normal cervical cells were discovered, results are negative. There is no need for further treatment/testing until the next Pap smear test.

Unclear 

If the cells collected from the cervix are unclear/normal/abnormal, the doctor may recommend testing right away to rule out any problem or may repeat the Pap Smear test with 6 months or a year.

Abnormal

If abnormal/unusual cells were discovered, you are said to have a positive result. To rule out cervical cancer/precancerous cells, further tests i.e. colonoscopy using a special magnifying instrument to examine the tissue of cervix and vagina are performed. The doctor also may take a tissue sample from any area that appears abnormal and send it to the lab for further analysis & a definite diagnosis.

If you have questions or want to talk about this further, please call Clinic One at 01-5400400/ 9863393960