Pap smear: Why, when, how ?

Pap smear: Why, when, how?

A few facts about female anatomy: The womb is also known as the uterus. It communicates with the vaginal canal; its opening into the vaginal canal is called cervix.

What is a Pap smear?

The name Pap is derived from the name of Dr.   George Papanicolaou, the originator of the Pap test. This is a simple painless test comprising two steps. The first step is collection of easily shed / scraped off cells from the opening of the womb i.e. the cervix, on a slide or in a bottle. The second step is examination of these cells under the microscope by a cytopathologist to detect abnormal cells.

What does an abnormal Pap smear indicate?

An abnormal Pap may indicate inflammation, infection, precancerous or cancerous change.

 

How does finding pre cancerous cells help?

Cancer of the cervix is India’s most common cancer as well as that of the developing world. It mainly occurs as a consequence of infection with the human papilloma virus. This infection results in transformation of  cells in the region of the cervix into abnormal dysplastic cells. Dysplastic cells left untreated, may transform into cancerous cells over a few years. However, if identified by a Pap smear and treated, conversion to cancer may be prevented. 

Why is a simple gynecological examination inadequate to do what a pap smear does?

Pap smears help in identifying abnormalities that are not visible  to the naked eye during examination. An abnormal pap smear in a lady with no obvious abnormal finding on examination, prompts the doctor to examine her under magnification using an instrument called colposcope. 

Who should undergo a Pap smear?

All women between the ages of 21 and 65-70 years, who are or have been sexually active, should undergo a Pap smear examination. 

How long does a Pap smear take? Is it painful?

Pap smears take around 5 minutes to perform. There is no pain; there may be some mild, transient, discomfort.

When should this test be performed?

The ideal time for women to undergo this test is 10 to 20 days after their period. Women who have undergone menopause may get the test done anytime.

It should be performed every 3 years. In case the test reveals an abnormality, a repeat test may be advised earlier than 3 years.

Why should a woman get a Pap test done?

The incidence of cervical cancer is very high in the developing world. The map above, courtesy the GLOBOCAN project,  illustrates the magnitude of the problem in South Asia, Africa and Latin America. A quarter of the world’s cancer cervix patients are Indian!

Pap smears can prevent this cancer, since precancerous abnormalities are amenable to outpatient gynecological procedures.

In patients in whom this disease has already occurred but is not causing symptoms, Pap smears may help detect the disease at an earlier stage.

In countries where Pap smears are performed regularly for screening, cervical cancer has become very infrequent.