A Pap smear test is a simple test to detect abnormalities in the cells of the cervix. These abnormal cells are the first warning signs of cervical cancer which, if left undiscovered and untreated, may be fatal.
What does a Pap smear test involve?
The cervical smear test is simple and usually painless. It can be carried out by your GP, or at a family planning clinic or a well-woman clinic.
To take the smear, the doctor must insert a speculum into the vagina to get a clear view of the cervix.
During a pap smear test a speculum is used to open the vagina, then the surface of the cervix is gently scraped with a flat stick.
The speculum used is a stainless steel instrument with a curved end. The woman usually lies flat on the examination couch with her knees drawn up and apart.
The doctor then slides the speculum into the vagina. The speculum handles are squeezed together to widen the jaws, opening the vagina to reveal the cervix.
With the cervix visible, the doctor looks for any signs of infection and, if found, takes a swab for laboratory analysis.
The cervix and the inside of the vagina will also be examined for warts, which increase the risk of developing cervical cancer.
Occasionally, a second scraping may be taken from inside the opening of the cervix. The scraped cells are smeared at once onto a microscope slide and dispatched to the laboratory.
Each cervical smear slide will be accompanied by a form which includes all relevant details about the medical background and gynecological condition of the woman.
How does the pap smear test examine the smear?
At the laboratory, the smear is examined under a microscope. If the cells are healthy, a ‘negative’ result is recorded on the form and copies are sent to your doctor.
Occasionally, there are not enough cells in the smear to be sure the result is negative. If this is the case, you will be recalled for a second smear.
A second smear may also be required if the cervix is infected since the resultant inflammation can obscure the view of the cells. In a minority of cases, the test can prove positive.
Normally, though, if the presence of abnormal cells is diagnosed, further investigation will be necessary.
What if the pap smear test is positive?
When a woman’s lie proves positive, she will usually be sent for further tests to establish the nature of the abnormality.
The first stage is usually an appointment at the colposcopy clinic. A colposcope is a microscope used for taking a detailed look at the cervix and the inside of the vagina.
If an abnormal area on the cervix is revealed, a biopsy will be taken. This involves inserting special forces into the vagina and then snipping off a sample of tissue from the cervix.
If the abnormality is mild, simple local ablative treatment (in which all diseased tissues are removed by excision) is typically adequate. In a few cases,
where it seems the abnormality is severe, an immediate cone biopsy or even a hysterectomy may be recommended.
A cone biopsy is a more complex form of biopsy carried out in hospital under general anesthetic.
It provides ‘Cloth diagnosis and cure, for it not only yields a sample for analysis but removes all the affected tissue at the same time.
A hysterectomy is an operation to remove the uterus, cervix, fallopian tubes and, occasionally, the ovaries.
When should I have a pap smear test?
The official recommended interval between tests is five years. However, most experts agree that all women should be tested at least once every three years to be reasonably sure of detecting cancer at an early stage.
If you are at a high risk of developing cervical cancer -perhaps because you have been infected in the past with genital warts or you have had the previous treatment for an abnormal smear.
You should have a test at least once a year. Screening regimes vary in the UK, but most general practices routinely call women for smears every 3-5 years.
Keep a record of when you last had a smear and called for an appointment if necessary.
When will I get the results of my pap smear test?
Waiting times for smear tests vary from area to area. Most doctors will contact you only if the test proves positive.
If you wish to be reassured, you must usually communicate with the doctor yourself.
WHAT IS THE CERVIX?
The cervix forms the lower end of the uterus where it projects into the vagina. It is often referred to as the neck of the uterus.
In the center of the rounded end of the cervix is a small opening filled with mucus.
A smear is usually taken from around the opening of the os.
Identifying infections during pap smear test
As well as revealing cancer, the pap smear test is useful for detecting unrelated diseases which can then be treated, such as
- Genital wart virus.
- Genital herpes.