A pap smear, also referred to as a Pap test, is a cervical cancer detection test. It involves taking cervical cells (cells in the lower, narrow end of the uterus, at the top of the vagina). Early cervical cancer detection through a Pap smear increases the chances of successful treatment.
A Pap smear test can detect early changes in the cervical cells that may develop into cervical cancer. Early detection of cervical changes is the first step in preventing the development of cervical cancer.
Why is a Pap smear necessary?
A Pap test is a screening for cancer of the cervix. It’s usually carried out with a pelvic exam. Women above 30 need the Pap smear test and the human papillomavirus (HPV) test. HPV is one of the most prevalent sexually transmitted infections that also causes cervical cancer. In some cases, an HPV test is required instead of a Pap test.
Who should get a Pap test?
Your doctor can inform you when you should begin Pap testing and how often you should get the test. Generally, doctors recommend that women start Pap testing from the age of 21.
How often do I need a Pap smear?
Generally, doctors recommend Pap smears every three years from age 21 to 65. Women from 30 years can get Pap smears every five years if they undergo the procedure alongside HPV testing or undergo HPV testing alone.
For women with certain risk factors, the doctor may recommend more frequent Pap testing regardless of age. The risk factors include the following;
- Exposure to diethylstilbestrol (DES) before birth
- A history of smoking
- HIV infection
- A weakened immune system resulting from transplanting an organ, chronic corticosteroid use or chemotherapy
- A diagnosis of cervical cancer or Pap smear with precancerous cells
You can discuss with your doctor the risks and benefits of Pap smears to decide your testing frequency.
Who should consider stopping Pap smears?
In some cases, the doctor and the patient may decide to stop Pap testing. These cases include:
- After a total hysterectomy
A total hysterectomy is a complete removal of the uterus and cervix. If you undergo this procedure, you can ask the doctor if you still need Pap testing.
If your hysterectomy was due to having a non-cancerous condition such as uterine fibroids, you might have to stop routine Pap testing. However, if the hysterectomy was due to precancerous or cancerous cervical cells, the doctor may recommend that you continue routine Pap testing.
- Older age
Doctors usually recommend stopping routine smear test London from 65 years if the previous Pap smears did not show precancerous or cancerous cervical cells.
You can discuss your options with the doctor to decide the best course of action, depending on your risk factors. If you are sexually active and have several partners, your doctor may recommend routine Pap testing.
Pap smears are a safe procedure to screen for cervical cancer, but this procedure is not foolproof. You could have a false-negative result, meaning the test will show no abnormal cells even when they are present.
A false-negative result doesn’t always mean an error occurred. Certain factors contribute to a false-negative result. They include:
- A small number of abnormal cells
- An insufficient collection of cells
- Inflammatory or blood cells obscuring the abnormal cells
Although abnormal cells can go undetected, cervical cancer takes some years to develop, so if one test doesn’t detect the abnormal cells, the next test will likely detect them.
How to prepare for Pap testing
Carrying out the following steps before your private smear test will ensure the procedure is more effective;
- Avoid scheduling your Pap test during your period
- Avoid sexual intercourse, using vaginal medicines, spermicidal foams, creams, jellies, or douching at least two days before your Pap test because they can obscure or wash away abnormal cells
What to expect
- During the Pap test
A Pap test takes only a couple of minutes in a doctor’s office. The healthcare professional may ask you to undress from your waist down or completely, then lie with your back on an examination table while keeping your knees bent and resting your heels in supports called stirrups.
The healthcare provider will gently insert a speculum in your vagina to hold your vaginal walls apart to see your cervix. While the doctor inserts the speculum, you may feel pressure in your pelvic area.
The doctor or nurse will take your cervical cell samples with a soft brush and a spatula. The sample collection doesn’t hurt, but you may feel a little discomfort.
After the Pap smear
After the Pap test, you can resume your normal activities. Depending on the type of Pap smear carried out, the doctor will transfer your cell samples from your cervix to a container with a special liquid to preserve your sample (liquid-based Pap test). If you had a conventional Pap test, the doctor would transfer your samples to a glass slide.
You can ask the doctor when to expect your result.
The result of your Pap test can tell the doctor if you have suspicious cells that require further testing.
- Normal results
If the Pap smear discovers only normal cervical cells, your result is negative. You will not need further testing or treatment until your next pelvic exam or Pap smear.
- Abnormal results
If your Pap smear result shows abnormal cells, your result will be positive. A positive result does not indicate cervical cancer. The meaning of a positive Pap smear depends on the type of cells discovered during the test.
The following are types of abnormal cervical cells and the next action they require.
- Atypical squamous cells of undetermined significance (ASCUS)
Squamous cells are flat and thin and grow on the surface of a healthy cervix. If the Pap smear shows ASCUS, it means that you have slightly abnormal squamous cells, but it doesn’t imply that you have precancerous cells.
With the liquid-based Pap test, the doctor can carry out another analysis of the cells to check for viruses such as certain types of HPV that may increase cancer risk. If high-risk viruses are absent, you don’t have a reason for concern. However, if further analysis reveals high-risk viruses, you may need further testing.
- Squamous intraepithelial lesions
This means that your cervical cells may be precancerous. In the case of low grade squamous intraepithelial lesions, the size, shape and other features of the cells indicate that if precancerous lesions are present, they may become cancerous in some years.
If the cell changes are high-grade, there is a higher risk of the lesions developing into cancer quickly. This requires additional testing.
- Atypical glandular cells
Glandular cells have mucus and develop in the opening of the cervix within the uterus. These cells may be slightly abnormal, but it is unclear if they are cancerous or not. They usually require further testing to know their source and significance.
- Squamous cell cancer or adenocarcinoma cells
When the doctor finds these cells, they are almost certain that cancer is present. A squamous cell cancer means that the cancer is in the flat surface cells of the cervix and requires immediate evaluation.
If your Pap test result is abnormal, the doctor may have to carry out a colposcopy. This procedure involves using a special magnifying instrument (colposcope) to examine the vagina, cervical and vulva tissues. The doctor may carry out a biopsy from abnormal areas then send the collected tissue samples to the lab for further analysis and a definitive diagnosis.
For a smear test near me, visit our private gynaecologist in London. You can contact us on 020 7183 0435 to schedule an appointment if you are due for your routine Pap test.