Everything You Need To Know About PAP Smear

For years, cervical cancer has been one of the most dangerous types of cancer for women besides breast cancer. It is responsible for the deaths of several women yearly. This type of cancer develops in the cells of the lower part of the uterus, known as the cervix. Cervical cancer can be prevented and treated through screening, so it is essential to go for a pap test.

The cervix

The cervix is a small and narrow passage or canal that connects the vagina to the uterus. The cervix also serves as an exit point from the uterus for monthly blood flow and a passage for a baby during delivery. There are two parts of the cervix, and two different types of cells occur in these parts. The two parts are as follows;

1. Endocervix: This is the innermost part of the cervix, and it lines the tunnel that leads from the uterus or womb to the vagina. It contains tall, column-like cells that are responsible for the secretion of mucus.
2. Ectocervix: This, on the other hand, is the outer part or portion of the cervix. It protrudes into the vagina and is home to squamous cells. The squamous cells closely resemble fish scales when viewed under the microscope.

The meeting point of these two cell types is often the site where most cervical cancers and other precancerous cells form.

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Pap smear

A pap smear test or a pap test is a screening tool that helps doctors detect abnormal or cancerous cells. To detect these cells, samples from the cervix would have to be taken. For early diagnosis of cervical cancer and possible treatment, it is important to go for screening. There are two tests that doctors recommend for this purpose, and they are;

•  The pap smear test that checks for the presence of abnormal cells
• The HPV (Human Papillomavirus) test that detects DNA from HPV and also reveals the presence and type of the virus

Through the help of this information, the doctor will determine if the patient has cervical cancer or not. The doctor will also determine if the individual has an increased risk of developing the disease. Summarily, the tests determine the following;

• Presence of cancer
• Presence of HPV
• Changes in precancerous cells

This means that cancer and HPV are the diseases that pap test can detect. If, after the test, there is a diagnosis, the individual can then seek treatment. Know that routine screening does not always include both tests; however, you can ask for an HPV test at the same time as a pap smear test.

What happens during a pap smear test?

A pap smear test is usually carried out during a gynaecological pelvic exam. You will have to lie on your back and place your feet in stirrups or foot rests for the test. Next, the doctor inserts a tool called a speculum into your vagina to keep the vaginal walls open and examine the cervix. A sample of the cervical cells is taken using a brush or a spatula, and the cells are placed in a petri dish and sent to the lab for testing.

For the test results not to be affected, it is best to avoid having the pap smear test during one’s menstrual period, especially if the flow is heavy. Also, you should not douche or insert anything into the vagina to clean it before the test.

When can one have a pap smear test?

The frequency of getting a pap smear test depends on several factors. These factors include;

1. Medical history
2. Age
3. HIV status
4. The strength of the person’s immune system
5. Exposure to diethylstilbestrol (DES) when in the womb

It is recommended that;

• Women aged 21-29 should go for a pap smear every 3 years
• Women aged 30-65 should go for a pap smear every 3 years and an HPV test every 5 years. They can also go for a pap and HPV co-test every 5 years

Women aged 65 and above do not really need a pap smear, although the risk factors of everyone vary. People who are sexually active with more than one partner and those who have had abnormal results in the past should get tested more often. Women who have had hysterectomy no longer need a pap smear unless the hysterectomy was due to cancerous or precancerous cells. In this case, they should continue going for a pap smear.

Pap smear results

After the pap smear test, it takes about 1 -3 weeks before the results come back. The results can either be positive or negative or others, but this does not mean a positive result indicates the presence of cancer cells. It simply means that more investigations should be conducted.

Normal results

If a test result comes back normal, it means the test does not reveal any abnormal cells.

Unclear results

In some cases, the results can be ambiguous, leading to the individual having more tests to monitor for any changes. The additional tests can either take place soon after the first test or six months later.

Abnormal results

If the test results are abnormal, the doctor may recommend more tests right away or after six months. It all depends on the extent of the cell changes. The cell changes can be classified as follows;

• Low-grade lesion: The risk of a low-grade lesion progressing to full-blown cancer is minimal.
• High-grade lesion: Unlike the low-grade lesion, the high-grade lesion has a higher chance of progressing to cancer sooner or later.
• Atypical glandular cells: These are abnormal cells present in the endocervix that will have to undergo further testing.
• Squamous cell cancer or adenocarcinoma: This is a cell that is likely to develop into cancer. Further testing would have to be conducted to confirm.

Cell abnormalities

Common cell abnormalities include the following;

Atypical squamous cells of undetermined significance (ASCUS):  These are mildly abnormal cells that do not meet the criteria for precancerous cells. The doctor may recommend additional testing.

Squamous intraepithelial lesions: These are cells that indicate possible precancerous cell changes that will require further testing.

Afterwards, a follow-up test can either be a colposcopy, followed by a biopsy or not. A colposcopy is a device used by the doctor to magnify the view of the cervix, vulva and vagina. Getting a pap smear test is one way to prevent and treat early-onset cancer. You can book a private smear test in London at Medical Express Clinic. Book an appointment with us through a call or email.