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By Dr Dulcy Rakumakoe

Chief Executive Officer


Why a pap smear is important

Doctors recommend repeating pap testing every two years for women between the ages of 21 and 65.


Let us first define what cancer of the cervix is. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer occurs when abnormal cells on the cervix grow out of control.

Cervical cancer can often be successfully treated when it’s detected early.

It is usually found at a very early stage through a pap smear test.

Cervical cancer is caused by the Human Papilloma virus (HPV), you can get HPV by having sexual contact with someone who has it.

Most adults have been infected with HPV at some time. An infection may go away on its own, but sometimes it can cause genital warts or lead to cervical cancer. That’s why it’s important for women to have regular pap tests.

HOW THE TEST IS DONE

The test is performed in your doctor’s office and takes only a few minutes.

You will be asked to lie down on an exam table with your knees bent. Your heels rest in stirrups. Your doctor will insert an instrument called a speculum into your vagina.

The speculum holds the walls of your vagina apart so that your doctor can easily see your cervix.

Inserting the speculum may cause a sensation of pressure in your pelvic area. Then your doctor will take samples of your cervical cells using a soft brush or a flat scraping device called a spatula.

It is not a painful procedure, but may be slightly uncomfortable.

Depending on the type of pap testing you’re undergoing, your doctor transfers the cell sample collected from your cervix into a container holding a special liquid to preserve the sample or onto a glass slide (conventional pap smear).

The samples are taken to a laboratory where they’re examined under a microscope to look for characteristics in the cells that indicate cancer or a precancerous condition.

WHO SHOULD HAVE A PAP SMEAR?

In general it is usually recommended that one begins pap testing at age 21, or any time after starting to have sexual intercourse. Doctors recommend repeating pap testing every two years for women ages 21-65.

If you have any of the aforementioned risk factors, your doctor may recommend more frequent pap smears, regardless of your age. Doctors generally agree that women can consider stopping routine pap testing at age 65 if their previous tests for cervical cancer have been negative.

Discuss your options with your doctor and together you can decide what’s best for you based on your risk factors.

If you’re sexually active with multiple partners, your doctor may recommend continuing pap testing.

RISKS

A pap smear is a safe way to screen for cervical cancer. However, a pap smear is not fool proof. It is possible to receive false negative results, meaning that the test indicates no abnormality, even though you do have abnormal cells.

Factors that can cause a false-negative result include:

  • An inadequate collection of cells.
  • A small number of abnormal cells.
  • Blood or inflammatory cells obscuring the abnormal cells.
  • Although it’s possible for abnormal cells to go undetected, time is on your side. Cervical cancer takes several years to develop.

To ensure that your pap smear is most effective, follow these tips prior to your test:

  • Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before having a pap smear, as these may wash away or obscure abnormal cells.
  • Try not to schedule a pap smear during your menstrual period. Although the test can be done, it’s best to avoid this time of your cycle, if possible.

RESULTS

A pap smear can alert your doctor to the presence of suspicious cells that need further testing.

If only normal cervical cells were discovered, you are said to have a negative result.

You will not need any further testing until you are due for your next Pap smear.

If abnormal or unusual cells were discovered, you are said to have a positive result.

A positive result does not mean you have cervical cancer.

What a positive result means depends on the type of cells discovered in your test.

If your pap smear is abnormal, your doctor may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. Your doctor also may take a tissue sample (biopsy) from any areas that appear abnormal.

The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis.

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Dr Dulcy Rakumakoe

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