All You Need to Know About Pap Smear

Introduction

A Pap smear, or Pap test, is a screening procedure for cervical cancer. It involves collecting cells from the cervix to detect abnormalities or early signs of cancer, allowing for timely intervention and prevention.

Uterus has 2 parts: Body and Cervix. The cervix is the narrow end of your uterus and is at the top of your vagina.

A Pap smear involves collecting the cells from cervix and then testing them for cancer or pre-cancerous changes. 

Early detection of these abnormal cells with a Pap smear is the first step in halting the possible development of cervical cancer and the early detection gives you a better chance at cure.

Pap smear is usually done along with your pelvic exam when you have gone for your routine gynaecological check-up. And in women elder than 30 yrs, pap test may be combined with HPV test; which is a common sexually transmitted infection that can cause cervical cancer.

Who should do pap smear and how often shoud it be repeated?

Under the age of 21: No pap smear necessary

Age 21 to 29: Pap smear once every 3 yrs

Age 30 to 65: Pap smear every 3 yrs or if combined with HPV; every five years

If you have certain risk factors, your doctor will recommend more-frequent Pap smears, regardless of your age. These risk factors include:

1.Abnormal Pap smear that showed precancerous cells

2.Weakened immune system due to long term steroid use; chemotherapy or organ transplant

3.HIV infection

4. Risky sexual practices like multiple partners

Who can stop testing for pap smear?

1.  After a total hysterectomy

2.  Before 21 years

3.  After 65 years; if your previous smears are consistently negative.

However, if you are sexually active with multiple partners; your doctor may recommend continuing Pap testing.

How To Prepare for Pap Test?

To ensure that your Pap test is most effective, follow these tips prior to your test:

• Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before having a Pap test, as these may wash away or obscure abnormal cells.

• Try not to schedule a Pap smear during your menstrual period. It’s best to avoid this time of your cycle, if possible

How is Pap Test Done?

• A Pap test is performed in your doctor’s office and takes only a few minutes. You may be asked to undress completely or only from the waist down.
• It is done on an outpatient basis and does not require any anaesthesia.

·         You’ll lie down on your back on an exam table with your knees bent. Your heels rest in supports called stirrups.

·         Your doctor will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of your vagina apart so that your doctor can easily see your cervix. Inserting the speculum may cause a sensation of pressure in your pelvic area.

·         Then your doctor will take samples of your cervical cells using a soft brush or a flat scraping device called a spatula. This usually doesn’t hurt.

What Are the Risks of Pap Smear?

A Pap smear is a safe way to screen for cervical cancer. However, a Pap smear isn’t fool proof. It’s possible to receive false-negative results — meaning that the test indicates no abnormality, even though you do have abnormal cells.

A false-negative result doesn’t mean that a mistake was made. Factors that can cause a false-negative result include:

• An inadequate collection of cells
• A small number of abnormal cells
• Blood or inflammatory cells obscuring the abnormal cells

Although it’s possible for abnormal cells to go undetected, time is on your side. Cervical cancer takes several years to develop. And if one test doesn’t detect the abnormal cells, the next test most likely will.

What happens after pap smear?

After your Pap smear, you can go about your day without restrictions.

Mild spotting, little abdominal cramps are normal. Some may get diarrhea due to stimulation of tiny nerve fibres .

Depending on the type of Pap testing you’re undergoing, your doctor transfers the cell sample collected from your cervix into a container holding a special liquid to preserve the sample (liquid-based Pap test) or onto a glass slide (conventional Pap smear).

The samples are transferred to a laboratory where they’re examined under a microscope to look for characteristics in the cells that indicate cancer or a precancerous condition.

Types of Pap Smear

Conventional pap smear: Here the cells are smeared directly onto glass slides and they are fixed immediately. The disadvantage is that; in this test, all cels may not be transferred onto the slides; affecting the accuracy of the test.

LBC or liquid based cytology: Here the cells are placed in to a vial with liquid preservative which preserves them for weeks and protects them. This is more accurate method to detect the abnormal cells in a pap smear

Results

Ask your doctor about when you can expect the results of your test. It usually takes 4 to 5 days to a week s time to get the results of your pap test.

A Pap smear can alert your doctor to the presence of suspicious cells that need further testing.

Normal results

If only normal cervical cells were discovered during your Pap test, you’re said to have a negative result. You won’t need any further treatment or testing until you’re due for your next Pap smear and pelvic exam.

Abnormal results

If abnormal or unusual cells were discovered during your Pap test, you’re said to have a positive result. A positive result doesn’t mean you have cervical cancer. What a positive result means depends on the type of cells discovered in your test.  

Once ready with the results of pap test; your gynaecologist will guide you further about the next test and the precautions you need to take.

Dr. Dimple Doshi is an expert gynaecologist practising at Vardaan Hospital Goregaon west Mumbai for last 20 yrs with a vast experience of dealing with womens gynecological problems. We  firmly believe that prevention is better than cure

We, at vardaan hospital do liquid based pap smear and often combine it with HPV DNA test for better accuracy.If proper and regular pap tests are done; cervical cancer can be detected in its very early stage or  far earlier than its actual development. We also offer vaccine prevention for HPV infections to the girls once they attain maturity.