Papanicolaou test or the Pap smear test is an examination of the cells taken from the tip of the cervix to detect premalignant and malignant process. Cervix is the lower part of the womb or the uterus that opens at the vagina. This test is a part of a gynecological exam. Pap Smear Test is done to detect cancerous or precancerous conditions of the cervix. Most of the cancers of the cervix can be found out early using this method and can be thus prevented. This test was invented by a doctor called Georgios Papanikolaou and is named after him.
This first Papanicolaou test should be done once you have had a physical intimacy lovemaking or if you are 21 years old. After that, women should perform the test regularly every 2 years. If the woman is over 30 years old, and the test has been negative for 3 times continuously, you may need to get it done every 3 years. Women who have had their uterus and cervix remove and have not had any case of cervical cancer before need not have this test done regularly. The screening guidelines vary from country to country. If there are no abnormal cells present in the cervix, the Pap Smear Test will show as negative.
If the result is abnormal, more tests are needed like biopsy or HPV tests. Abnormal results does not necessarily mean the condition of cancer, it could be a vaginal or cervical infection. If the test is ‘normal’ it means the cervix is healthy. If result is ‘unsatisfactory’ it means the sample taken of the cells was not a good sample and cannot be read properly. In this case the Pap Smear Test needs to be repeated again. ‘Benign changes’ would mean that you might have an infection and ‘ASCUS’ means more tests may be done to find if HPV is responsible for the changes. ASCUS is the short form for Atypical Squamous Cells of Undetermined Significance.
Papanicolaou test may be little uncomfortable as it may create a feeling of pressure during the procedure similar to that of menstrual cramps. One should avoid taking Pap Smear Test while menstruating since it may affect the accuracy of the test results. Also women should avoid douching or intimate lovemaking 24 hours before the test. Vaginal creams, diaphragms and tampons should not be used or inserted 24 hours before taking the test and the woman should empty bladder just before the Pap smear test to reduce discomfort.
In this test the cells are gathered from the outer opening of the cervix using a tool and then these cells are smeared or spread on a slide and placed under a microscope. The aim is for checking any abnormalities and to detect the pre cancerous changes which are caused by human papillomaviruses or HPVs. Women who have an increased risk of cervical cancer, HIV infection and decreased immunity need to be screened frequently. One may notice slight spotting after the Pap Smear test is performed and the results should be available after a couple of days. It is a relatively painless and safe procedure. Papanicolaou test is the most effective screening method developed in prevention of cancer. In the countries where Pap smear tests are not routinely performed, the percentage of women being affected by cancer is higher.
What do the results mean?
A normal Pap smear means that all the cells in your cervix are normal and healthy. An abnormal Pap smear can be a sign of a number of changes in the cells on your cervix, including:
- Inflammation (irritation). This can be caused by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV) the herpes virus or many other infections.
- Abnormal cells. These changes are called cervical dysplasia. The cells are not cancer cells, but may be precancerous (which means they could eventually turn into cancer).
- More serious signs of cancer. These changes affect the top layers of the cervix but don't go beyond the cervix.
- More advanced cancer.
How reliable is the test?
No test is perfect, but the Pap smear is a reliable test. It has helped drastically lower the number of women who die of cervical cancer.
Sometimes the test may need to be redone because there were not enough cells on the slide. The lab will tell your doctor if this happens.
ThinPrep, PAPNET and FocalPoint are ways to make Pap smears more accurate. ThinPrep is a way of preparing the sample of cells that makes it easier to spot abnormalities. PAPNET and FocalPoint are computer systems that help lab technicians find abnormal cells. These options may not be available in all areas, and they may increase the cost of a Pap smear.
Sometimes the test may need to be redone because there were not enough cells on the slide. The lab will tell your doctor if this happens.
ThinPrep, PAPNET and FocalPoint are ways to make Pap smears more accurate. ThinPrep is a way of preparing the sample of cells that makes it easier to spot abnormalities. PAPNET and FocalPoint are computer systems that help lab technicians find abnormal cells. These options may not be available in all areas, and they may increase the cost of a Pap smear.
What should I do before the test?
Plan to have your test done at a time when you aren't having your menstrual period. Don't douche, use a feminine deodorant or have intimacy for 24 hours before the test.
What happens if my Pap smear is abnormal?
If the results of your Pap smear are abnormal, your doctor may want to do another Pap smear or may want you to have a colposcopy.
A colposcopy gives your doctor a better look at your cervix and allows him or her to take a sample of tissue (called a biopsy). Your doctor will use an instrument called a colposcope to shine a light on your cervix and magnify it. Your doctor will explain the results and discuss treatment options with you.
A colposcopy gives your doctor a better look at your cervix and allows him or her to take a sample of tissue (called a biopsy). Your doctor will use an instrument called a colposcope to shine a light on your cervix and magnify it. Your doctor will explain the results and discuss treatment options with you.
What puts me at risk for cervical cancer?
Risk factors for cervical cancer
Is there anything I can do to avoid getting cervical cancer?Risk factors for cervical cancer
- Starting to have intimacy early (before age 18)
- Having had many intimate partners
- Being infected with a intimate transmitted infection (STI) or having had a intimacy partner who has an STI
- Smoking
The main risk factors for cervical cancer are related to intimate practices (see the box to the right). intimate transmitted infections (STIs) may make your cells more likely to undergo changes that can lead to cancer. STIs include HPV, herpes, gonorrhea and chlamydia. HPV is the virus that can cause genital warts. It seems to be very closely connected with these changes.
You may be able to reduce your risk of cervical cancer if you:
- Delay intimate intercourse until you're 18 years of age or older.
- Make sure both you and your partner are tested for intimate transmitted infection (STIs).
- Limit your number of intimacy partners.
- Always use latex condoms to protect against STIs. (Remember condoms aren't 100% effective.)
- Avoid smoking.
What is Gardasil?
Gardasil is used to prevent genital warts and cervical/vaginal/anal cancers caused by human papillomavirus (HPV) types 6, 11, 16, and 18 in girls and young women ages 9 through 26. Gardasil is also used to prevent genital warts caused by HPV types 6 and 11 in boys and young men ages 9 through 26. Human papillomavirus (HPV) can cause genital warts, cancer of the cervix, and various cancers of the vulva or vagina.
The quadrivalent form of HPV vaccine (Gardasil) is used in both females and males. Another form of HPV vaccine (Cervarix) is used only in females. This medication guide provides information only for Gardasil.
The Centers for Disease Control and Prevention (CDC) recommends HPV vaccine for all girls ages 11 or 12 years old. The vaccine is also recommended in girls and women ages 13 through 26 years old who have not already received the vaccine or have not completed all booster shots.
You may receive Gardasil even if you have already had genital warts, or had a positive HPV test or abnormal pap smear in the past. However, Gardasil will not treat active genital warts or HPV-related cancers, and it will not cure HPV infection.
Important information about Gardasil
You should not receive a booster Gardasil vaccine if you have had a life-threatening allergic reaction after the first shot.
The Centers for Disease Control and Prevention (CDC) recommends HPV vaccine for all girls ages 11 or 12 years old. The vaccine is also recommended in girls and women ages 13 through 26 years old who have not already received the vaccine or have not completed all booster shots.
Gardasil should not be used in place of having a routine pelvic exam and Pap smear to screen for cervical cancer. You may receive Gardasil even if you have already had genital warts, or had a positive HPV test or abnormal pap smear in the past. However, Gardasil will not treat active genital warts or HPV-related cancers, and it will not cure HPV infection. You may feel faint after receiving Gardasil. Some people have had seizure-like reactions after receiving this vaccine. Your doctor may want you to remain under observation during the first 15 minutes after the injection.
Developing cancer from HPV is much more dangerous to your health than receiving the vaccine to protect against it. However, like any medicine, Gardasil can cause side effects but the risk of serious side effects is extremely low.
Gardasil will not protect against intimate transmitted diseases such as chlamydia, gonorrhea, herpes, HIV, syphilis, and trichomoniasis.
This PAP Smear test will do all Gynecologist Doctors(DGO)
Neelima Hospital in Motinagar (040-65264448) and Erragadda (040-64617475) - Dr. Neelima.
