PAP SMEAR / CERVICAL CANCER SCREENING

Cervical cancer can almost always be prevented, and having regular Pap smear tests is the key.

Facts about Pap Smear

 

Pap smear  is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb).

For many women the test results show that everything is fine.

But for around 1 in 20 women, the tests show changes in cells that can be caused by many things.

Most of these changes will not lead to cervical cancer.

Pap smear is also a test for the  human  papillomavirus (HPV). Certain types of HPV can cause abnormal changes in the cervix and  might also leads to cervical  cancer.

Importance of Pap smear

 

Cervical cancer can often be prevented. The signs that it may develop can be spotted early on so it can be stopped before it even gets started.

However many of those who develop it have not been screened regularly.

Not going for cervical screening is one of the biggest risk factors for developing cervical cancer.

Timing of Pap smear  

 

  • Women should not be tested during period.

  • Pap smear should be done before or after a period is due. The best time is in the middle of  menstrual cycle (eg.  if a woman’s menstrual cycle is 4 weeks, 2 weeks after the first day of her last period).

  • In Malaysia,  women aged 20-65 years old who are sexually  active  should have pap smear test initially yearly for 2 years, if both tests are normal, they should have Pap smear test every 3 years.

  • For women age more than 30 years old, they are recommended to have 'combined test' which includes Pap smear / cervical screening test (Liquid based cytology) with HPV DNA test.

 

To make a Pap smear as accurate as possible, for 48 hours before the test, DO NOT:

  • Have sex

  • Use tampons

  • Douche

  • Use vaginal lubrication

  • Insert creams, suppositories, or medication into the vagina

  •  Use vaginal sprays or powders

 

How is a Pap Smear done?

 

The doctor uses an instrument called a speculum that goes inside the vagina and opens, so the cervix can be seen.

A small stick or brush is used to take cell samples from around and inside the cervix.

The sample is sent to a lab where it is examined under a microscope to see if any abnormal cells are present.

Are Pap Smear tests reliable?

 

Early detection and treatment of abnormal cells can prevent around 75% of cancers developing but like other screening tests, it is not perfect.

It may not always detect early cell changes that may lead to cancer.

 

Abnormal cells may not be recognized because:

  • sometimes they do not look much different from normal cells

  • there may be very few abnormal cells collected

 

About 1 in 20 tests have to be taken again because:

  • There was  infection around the cervix which needs to be treated before a clear slide can be made

  • the cervical cells on the slide may have been hidden by blood or mucus/secretion

  • not enough cervical cells on the slide to give an accurate assessment

  • the sample may not have been properly   prepared

  • the slide may have been broken.

 

How can the risk of developing cervical cancer be reduced?

  • Regular Pap smear.

  • Stop smoking (smoking is associated with persistent HPV infection)

  • HPV vaccination 

 

References;

  1. www.cancerscreening.nhs.uk

  2. U.S. Department of Health & Human Services

 

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