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Why is Pap Smear Test Important for Females?

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If you have questions or want to talk about this further, please call Clinic One at 01-5009233/ 9863393960

About the Test

Pap Smear Test / Papanicolaou test is a procedure to test for cervical cancer in women.
It is the method of cervical screening used to detect potentially precancerous & cancerous processes in cervix by exfoliating cells from cervix and analyzing them microscopically.

Worldwide, approximately 5,00,000 new cases of cervical cancer are diagnosed and 2,74,000 deaths result from it annually, making it the second most common cause of death from cancer in women. (WHO, 2018). In case of Nepal, according to Human Papilloma virus & related cancers Fact Sheet 2018, 10.16 million Nepalese women aged 15 years & older have risk of developing cervical cancer – making cervical cancer the most frequent cancer among Nepalese women.

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. Mainstay of cervical cancer screening has been Pap Smear Test.

In the Pap Smear Test, the collected cells are released into vial of liquid preservative that is used in by 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 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, Pap smear is not recommended for non-sexually active females since about 99% of cervical cancers are attributed to infection from Human Papilloma Virus (HPV), which are transmitted sexually.

Furthermore, if the result of the Pap smear are abnormal, depending on the nature of 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 uterus) because of abnormal cancerous cells or cervical cancer, you should continue to have a Pap Smear. If the uterus is removed but cervix is still there, then regular Pap smear is needed until the age of 65.

Who can consider stopping Pap smear?

  • Never had sexual contact
  • Under the age of 21, regardless of sexual history
  • Over the age of 65, if previous test of 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?

  • 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 you can 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 vagina apart. A soft brush and flat scraping device called a spatula is 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.

Results of Pap Smear

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 is 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 special magnifying instrument to examine tissue of cervix and vagina are performed. The doctor also may take tissue sample from any area that appears abnormal and send 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 01-5009233/ 9863393960

By Soni Kayastha

Registered Nurse

 

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