You might be thinking the word Pap smear doesn’t sound so familiar and doesn’t sound like a disease or a medical condition. Yes, you got it right! The word Pap smear is actually not a disease it is an effective diagnostic test that detects the presence of cancerous growth in the cervix of a women. Cervix is the region that is present between your vagina and uterus. Cervical cancer is the second most common cancer affecting women and is responsible for causing more number of deaths in developing countries. Cervical cancer is caused by a virus called as Human Papilloma Virus (HPV), which spreads through sexual contact. The immune system of your body is able to fight and defeat HPV infection many times but if you are at high risk for cervical cancer than the HPV infection may result in cancer. These abnormal cancerous cells are found using a pap smear. By getting a pap smear done regularly you can find and treat these cells before they get converted into cancer.
Preparing yourself for Pap smear
There are many thing that can interfere with your test results, therefore it is important that you follow few do’s and don’ts before going for a pap smear. It is suggested that 2 days before the test you should avoid
- Douching (vaginal rinsing)
- Using tampons
- Using vaginal sprays or deodorants
- Using vaginal creams, suppositories, and medicines
- Having sex
- Taking a tub bath
- Using spermicidal foams
Pap smears are not done during periods. The best time to have a Pap smear done is between 10 days to 20 days after your menstrual cycle.
Procedure
When you visit your doctor, he or she will ask you to lie down and place your feet in the stirrups to properly position your pelvis for examination. Now your doctor will put a special sterile instrument called speculum into your vagina to open your vagina so that she can take sample from the cervix. Once the cervix is visible she will wipe the cervix with a cotton swab and collect cells from the cervix using a small brush or spatula or cotton swab. The collected sample will now be placed in a glass slide and will be sent to the laboratory for further investigation under a microscope.
The collected cervical cell sample is sent to the laboratory where it is stained using a special dye (Pap stain) and viewed under a microscope. The cells are checked for signs of cancerous development. Before actually developing into a fully fledged cancer growth the cervical cells undergo many stages. If the cells are caught before becoming cancerous and treated than cervical cancer is not life threatening anymore. Therefore, it is very important that you have your Pap smear done regularly.
Pap smear results
You will get your Pap smear result only after 3 weeks. The result will be given either as negative or positive.
Negative result: A negative result means that there was no cancer or abnormal cells detected in your sample. You may need no further tests.
Positive result: The following words will be used to describe results that were not normal
- Benign changes: This means that your cells are normal but there is a high chance of developing an infection. Now your physician might do a detailed pelvic examination to find out the exact cause of the infection.
- Atypical squamous cells of undetermined significance (ASCUS): This means that there are few abnormal cells present. This would require few more tests to determine whether it is caused by HPV
- Low-grade dysplasia (LSIL) and high-grade dysplasia (HSIL) means that the cells are in pre-cancerous condition
- Carcinoma in situ: Which means that abnormal cells are progressing into cancerous cells
- Atypical squamous cells (ASC–H): Abnormal cells found and may be HSIL
If your Pap smear results are abnormal or shows any abnormal cells your doctor may recommend few more test to confirm or identify the cause of abnormal result. Sometime he may ask you to repeat your Pap smear. In case of abnormal results few advanced tests that your doctor may perform are
- HPV test: This test detects for the presence of cancer causing HPV in the cervical cells
- Colposcopy: A tool to examine vaginal or cervical cells in detail
- Endocervical curettage: A small amount of cells are scrapped from the endocervical region using a currete
- Biopsy: A small sample of the cervical tissue is removed from the cervix and sent to lab for further tests
- LUMA cervical imaging system: A recently introduced advanced technique which is used right after colposcopy. This device examines the cervical cells that are suspected to have pre-cancerous cells. It further makes a color map that helps your physician to decide the area to perform a biopsy.
Pap smear for screening
It is usually recommended that you should start having your Pap smear test done once you are sexually active or if you are above 18 years of age. You can also consult your doctor for a scheduled planner of when to have a Pap smear done. You should have your Pap smear done repeatedly until you have 3 continuous normal results. After 3 normal results, you can talk to your doctor about spacing your Pap smear follow up tests. It is recommended that you have your pap smear done atleast once every 3 years, even after menopause, until your doctor say you need them no more. If you are older than 65 years and had normal Pap results, then consult with your doctor before stopping the tests.
Pap smear reliability
As with any other tests Pap smears may also show false positive or false negative results. This may be due to many factors such as too less sample with too few cells to study. There may be no sufficient abnormal cells or an infection or blood may mask the cells. In addition, vaginal rinsing or medication may wash away or dilute abnormal cells. Inspite of this, Pap smear is considered a very effective diagnostic tool, if performed properly, as it has considerably reduced the number of deaths due to cervical cancer.
Ways to avoid cervical cancer
Following few preventive measures helps to avoid cervical cancer
- Do not indulge in sexual activity until you are 18 years
- Make sure that you and your partner get tested for sexually transmitted disease
- Have sex with limited number of partner
- Always have protected sex
- Quit smoking
Conclusion
Having an abnormal pap smear result is of course a reason to worry because abnormal cells may develop into cancerous cells in no time or increase the risk of cervical cancer. Talk to your doctor about the results and consult with him about what your results mean and what steps should you take next. Remember to do follow-up check-ups as they help to detect the problem at an earlier stage.
