| Pap smear | |||||
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A pap smear (or pap test) is a gynaecological screening test performed on women to test the cervix for any abnormal cells to detect any disease of the cervix.
A pap smear can be performed by a regular doctor or it can be performed by a specialist (a gynaecologist).
A pap smear is performed by the doctor inserting a speculum inside the woman's vagina to widen it, in order to insert a swab and take a sample of cells inside the cervix. These cells are placed on a glass slide and sent to a laboratory for examination.
Pap smear cell abnormalities fall into the following categories starting from the least abnormal to the most malignant (from the National Cancer Institute):
| Pap Smear Result | Meaning |
| Dysplasia |
Abnormal cells. |
| There are four degrees of dysplasia: (1) mild (2) moderate (3) severe (4) carcinoma in situ (cancer in one place and not spread to other tissues) |
|
| Squamous Intraepithileal Lesion (SIL) |
Abnormal cells changes in the cells on the surface flat cells of the cervix. |
| There are two types of SIL: (1) Low grade - early changes in the size, shape, and number of flat (squamous) surface cells (2) High grade - abnormal, pre-cancerous cells that are very different to surrounding cells |
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| Cervical Intraepithileal Neoplasia (CIN) | Abnormal growth of cells on the surface of the cervix. |
| CIN 1 - 1/3 of the surface of the cervix has abnormal cells (mildly abnormal cells) CIN 2 - 2/3 of the surface of the cervix has abnormal cells (moderately abnormal cells) CIN 3 - All of the surface of the cervix have abnormal cells (severely abnormal cells), also called carcinoma in situ |
|
| Atypical Squamous Cells |
Unclear results - require a repeat pap smear. |
| Could be due to a number of factors: * infection (candida, HPV, herpes) * use of medication * improper amount of cells used for test |
|
| Cervical Cancer | Abnormal cells which have spread deeper into the cervix or to other tissues or organs. |
Pre-cancerous changes of the cervix will not necessarily develop into cancer, but they do need to receive medical attention.
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- A Pap smear is a simple, quick, and generally painless screening test (although some women may feel a little bit of discomfort)
- A pap smear helps to prevent cancer of the cervix by detecting abnormal cervix cells before they develop into cancer
- While the best defence against cancer of the cervix, a pap smear is not 100% foolproof (although it does come close)
- The best time in the menstrual cycle to have a pap smear is anywhere from 5 days before to 5 days after ovulation
- Pap smear testing is recommended within three years of vaginal intercourse or at age 21, whichever comes sooner (even for girls who have never had intercourse)
- A pap smear should be performed every two years for most women aged 16 to about 70
- Women who have abnormal cells detected in their pap smear are normally advised to have a repeat pap smear or even colposcopic evaluation, depending on the result
- Some substances affect the pap smear test - some medications, douches, semen,
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A regular pap smear is the best way to avoid cancer of the cervix, as abnormal cells can be detected a very long time before they turn into cancer of the cervix.
In 2007, a new vaccine against a few of the different types of Human papilloma viruses (HPV) viruses which cause cancer of the cervix has recently been developed by Australian researchers was administered to girls and women in Australia.
While the Human papilloma viruses (HPV) are the ones which are the main culprit for causing cancer of the cervix and for which the cervical cancer vaccine was developed (it is not foolproof), so it is still necessary for women to have a regular pap smear.
references
- Lark SM. The Menopause Self-Help Book: A Woman's Guide to Feeling Wonderful for the Second Half of Her Life. 4th Edition, 1990. Celestial Arts Publishing
- National Cancer Institute USA. http://www.cancer.gov/cancertopics/factsheet/Detection/Pap-test, accessed 30 Sep 07
- Rushing L, Joste M. Abnormal Pap Smears: What Every Woman Needs to Know. 1st edition, 2001. Prometheus Books
To learn more, go to the following web sites:
- Dept Health and Ageing - Pap Smear (Australia)
- Dept Healths & Human Services, Tasmania (Australia)
- National Institute of Health (USA)
- Health Canada
