A Pap smear, also called a Pap test, is a screening procedure for cervical cancer. The main purpose of a Pap smear test is to identify cellular changes in the cervix, which could be caused by HPV. It tests for the presence of precancerous or cancerous cells on your cervix, which is the opening of the uterus.

Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.

If you’ve ever had a pelvic exam, the Pap test isn’t much different. You’ll lie on the table with your feet in stirrups. A speculum will be used to open your vagina and allow your doctor to see your cervix. During the routine procedure, cells from your cervix are gently scraped away and examined for abnormal growth. The procedure is done at your doctor’s office. It may be mildly uncomfortable but doesn’t usually cause any long-term pain

The Role of Pap Smear in Early Diagnosis of Cervical Cancer

Cervical cancer

Cervical cancer is the third most common malignancy in women worldwide, and it remains a leading cause of cancer-related death for women in developing countries.  Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries.

Cervical cancer is one of the few preventable human cancers.

The high mortality rate from cervical cancer globally could be reduced through a comprehensive approach that includes prevention, early diagnosis, effective screening and treatment programmes. There are currently vaccines that protect against common cancer-causing types of human papillomavirus and can significantly reduce the risk of cervical cancer. Two strains of HPV — HPV 16 and 18 — account for at least 70 per cent of cervical cancer cases. HPV Vaccination can protect against contracting these strains. Gardasil 9 is the lastest HPV vaccine that gives more protection.

Read: HPV Warts & Genital Warts Treatment

Who is at risk of Cervical Cancer?

Knowing the warning signs as well as your risks increases your chances of early detection of cervical cancer and HPV before it progresses. Risk factors for cervical cancer include:

• already infected with high risk strain of HPV
• long-term oral use of oral contraceptive pills
• a weakened immune system – HIV positive patients, patients undergoing chemotherapy
• mother’s use of a synthetic form of the female hormone estrogenused  during pregnancy

Risk factors for HPV include:

• a high number of sexual partners- this just increases the probability that one of your partners is carrying HPV
• first sexual intercourse at a young age
• a weakened immune system
• Never vaccinated with the HPV vaccine

What to expect from the pap smear results?

Normal Pap smear

If your results are normal, that means that no abnormal cells were identified. Normal results are sometimes also referred to as negative. You won’t need any further treatment or testing until you’re due for your next Pap smear and pelvic exam.

Abnormal Pap smear

If the test results are abnormal, this doesn’t mean you have cancer. It simply means that there are abnormal cells on your cervix, some of which could be precancerous. Abnormal cells are either low-grade or high-grade. Low-grade cells are only slightly abnormal. High-grade cells look less like normal cells and may develop into cancer. There are several levels of abnormal cells:

• atypia
• mild
• moderate
• severe dysplasia
• carcinoma in situ

Milder abnormal cells are more common than severe abnormalities.

Some other reasons for an abnormal result are:

• inflammation
• infection
• herpes
• trichomoniasis
• HPV

Depending on what the test results show, the doctor may recommend:

• increasing the frequency of your Pap smears
• getting a closer look at your cervical tissue with a procedure called colposcopy

During a colposcopy exam, the doctor will use light and magnification to see vaginal and cervical tissues more clearly. In some cases, they may also take a sample of your cervical tissue in a procedure called a biopsy.

When should you get a pap smear done?

Current medical guidelines recommend that women get regular Pap smears every three years starting at age 21. Some women may be at increased risk for cancer or infection. You may need more frequent tests if:

• you’re HIV-positive
• you have a weakened immune system from chemotherapy or an organ transplant
• Family history of cervical cancer
• OCP abuse-Taking birth control pills for 5 or more years might make you more likely to get cervical cancer. The longer you use them, the higher your risk.
• Smoking- Tobacco by-products have been found in the cervical mucus of women who smoke. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections

All women who are, or who have been sexually active, between the ages of 30 and 65 years are recommended to undergo Pap smear testing. If the first two consecutive Pap results are negative, screening every three years is recommended.

Because screening is for women who don’t have symptoms or a recent history of abnormal results, these screening recommendations do not apply to women—

• With a prior diagnosis of a high-grade precancerous cervical lesion or cervical cancer,
• With  exposure to synthetic female hormones during pregnancy, or
• Who are immunocompromised (such as those who are HIV positive, organ transplant recipients, or on chronic immunosuppressants).

These women are considered at increased risk for cervical cancer and may need to be screened more often; they should receive individualized follow-up based on their specific conditions.

If you’re due for a Pap test and you’re pregnant, then you can have one up to 24 weeks into your pregnancy. You can even have a colposcopy. Having an abnormal Pap or a colposcopy while pregnant shouldn’t affect your baby.

After the sixth month and until 12 weeks after birth, you shouldn’t have a Pap smear. Because during the last three months of your pregnancy, a Pap test could be uncomfortable. If you need additional treatment, your doctor will advise if it should wait until your baby is born. After birth, you could get unreliable results due to insufficient or inflammatory cells present after birth. Wait 12 weeks post delivery before you do a pap smear test.

Don’t wait until it’s too late!

Cervical cancer doesn’t usually cause symptoms until it’s in the advanced stages. Also, women may think the symptoms are related to something else, such as their menstrual cycle, a yeast infection, or a urinary tract infection.

Examples of symptoms associated with cervical cancer include:

• abnormal bleeding, such as bleeding between menstrual periods, after sex, after a pelvic exam, or after menopause
• discharge that’s unusual in amount, color, consistency, or smell
• urinating more frequently
• pelvic pain
• painful urination

More severe symptoms may arise at advanced stages.

All women should have regular cervical cancer screenings. You can lessen your cervical cancer risk by reducing the likelihood you’ll get HPV. If you’re between the ages of 9 and 45, you can get the HPV vaccine.

While there are different kinds of HPV vaccines on the market, they all protect against types 16 and 18, which are the two most cancer-causing types. Some vaccines provide immunity against even more HPV types. It’s ideal to get this vaccine before becoming sexually active.

The more strains of HPV the vaccination protects, the better it is for you. There are more than 40 strains of HPV being studied now.  The Gardasil 9 vaccine is available for the prevention of genital warts and cancers caused by HPV. The vaccine can protect against nine types of HPV known to be associated with either cancer or genital warts.

Take Care