The Dreaded Pap Test Can Save You From Cervical Cancer
What Is It?
The Papanicolaou Smear [aka Pap Test, Pap Smear] is performed as part of a routine pelvic exam. The Test is used detect precancerous cells, inflammation, infection and abnormalities of the cervix – including cervical cancer. Approximately 20,000 new cases of cervical cancer are diagnosed annually and account for an estimated 7,600 deaths each year. The Pap Test can detect the earliest signs of this cancer, and is the best way to ensure early intervention and treatment.
How Is It Performed?
After “assuming the position,” the gynecologist will introduce a speculum into the vagina. A speculum is a small instrument used to open the walls of the vaginal canal, affording visualization of the interior. A sampling of cells is then taken from the cervical canal by scraping the outside of the cervix with a device remarkably resembling a spatula, followed by the insertion of a small brush (the cervix brush or “Papette, which looks not unlike, of all things, a pipe cleaner). Once the cell samples are taken, they are fixed to a slide or placed in a bottle containing preservative and sent off to a lab.
The entire procedure can range between 10-20 minutes and can be mildly, albeit temporarily, painful.
What Should You NOT Do Before a Pap?
Do not schedule your Pap during menstruation. The optimum time to undergo the Test is approximately 10-20 days *after* the *first day* of your *last* period. Avoid intercourse, baths, douching and use of vaginal creams, suppositories, foams, medications, deodorant sprays or powders for 24 hours prior to the Test in order to avoid inaccurate results.
What Happens After?
If your results are normal – “negative” – nothing further is needed. If abnormal results are reported – “positive” – further investigation will be performed. In the case of infections, appropriate treatment will be prescribed. In the case of cell changes, a colposcopy may be performed, in which a special microscope is used to examine the cervix very closely. A biopsy will also likely be taken and further tested for abnormalities.
Paps are highly effective, but there is a slight chance of “false positive” or “false negative” results. In such cases, you and your physician will decide on the correct course of further testing and/or treatments.
When – and How Often – Should You Get Tested?
Previously, women began undergoing Pap Tests after becoming sexually active or at age 18, whichever came first. Updated guidelines now call for screening to start approximately 3 years after first sexual intercourse or age 21, whichever comes first. Many gynecologists also previously recommended annual screenings; however, the updated guidelines now recommend continued annual screenings only for women age 30 and under, and in those women 30 and over who have had positive results on previous Paps. Those women who have had negative results in three previous consecutive Paps may be advised to undergo screenings every 2-3 years. Of course, there are always exceptions. High-risk women will receive more frequent screenings based on their personal situations and at their doctor’s discretion.
Women who have had a total hysterectomy with removal of the cervix for non-malignant reasons may discontinue routine Paps at their personal physician’s recommendation, however; women who have undergone hysterectomy, but have a history of abnormal cell growth, should continue to undergo annual Paps until their gynecologist recommends otherwise.
Your gynecologist will determine when you can stop having Pap screenings based on your personal situation; generally, this ranges between ages 60-70.
Regardless of how often you and your physician decide you should have a Pap Test, you should still be sure to undergo your annual pelvic and gynecologic exams.
“A Necessary Evil”
Most women will agree, undergoing a Pap Test is not high on their list of favorite things to do. However, this relatively quick procedure can detect – and facilitate proper and timely treatment of – various infections and one of the most common cancers. It is important to undergo routine screenings based on your gynecologist’s recommendations: the Pap Test can save your life.
Sources:
National Women’s Health Information Center, U.S. Department of Health & Human Services, Office on Women’s Health:
http://www.4woman.gov/faq/pap.htm#2
U.S. National Library of Medicine, National Institutes of Health, Department of Health & Human Services:
http://www.nlm.nih.gov/medlineplus/ency/article/003911.htm
American College of Obstetricians & Gynecologists (ACOG):
http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm
“Optimizing the Papanicolaou Smear,” by E.J. Mayeaux, MD, LSU Health Sciences Center:
http://www.sh.lsuhsc.edu/fammed/OutpatientManual/PapSmear.htm
