What is a Pap smear test?
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina.
How can I prepare for the Pap smear test?
Some tips prior to your test:
- Try not to schedule a Pap smear test during your menstrual period.
- Avoid intercourse 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.
How is a Pap smear test performed?
The Pap smear test is performed in your doctor’s office and takes only a few minutes. For this test the doctor will ask you to undress from the waist down.
A speculum made from disposable plastic (or from metal, which should be warmed) will be inserted vaginally to view the squamocolumnar junction of the cervix. This speculum functions to hold the walls of the vagina apart, so the doctor can see the cervix. A soft brush or spatula is used to take samples of your cervical cells. The procedure can be a bit uncomfortable, but a Pap smear test should not hurt.
After the procedure your doctor transfers the cell sample collected from your cervix into a container with a special liquid to preserve the sample, this method is called Liquid-Based Cytology (LBC). This is the chosen method internationally. LBC has significantly reduced numbers of inadequate smears, as the liquid is spun and treated to remove other cells such as pus or blood.
The samples are transferred to our laboratory where they will examine the sample under a microscope to look for characteristics in the cells that indicate cancer or changes indicating precancerous conditions.
Can I do everything after the Pap smear test?
There are no restrictions after the Pap smear test is performed. Most women do not experience side effects, though some might experience light bleeding afterwards.
What are the possible outcomes?
To give an overview of the possible outcomes of the test, we listed the categories below:
Normal results
If only normal cervical cells are discovered, you will be informed that the result of your Pap smear test is ‘negative’. In this case you won't need any further testing until you're due for your next Pap smear test.
Abnormal results
The cervical samples may show:
- Borderline changes in squamous or endocervical cells. Cells are seen with abnormal nuclei, but the pathologist cannot say for certain that they are indicative of abnormal nucleus (epithelial cells). Many patients revert to normal smears eventually. Very few of these patients go on to develop cancer.
- Low-grade abnormal nucleus. Again, many women with this finding eventually revert to normal smears. Cancer is very unlikely.
- High-grade abnormal nucleus (moderate). This usually equates to a pre-cancerous condition with an intermediate probability of developing into cancer.
- High-grade abnormal nucleus (severe). It is at the higher risk end of the cancer spectrum.
- Invasive squamous cell cancer. "Squamous cell cancer" refers to cancers arising in the flat surface cells of the vagina or cervix.
- Glandular neoplasia. Occasionally, abnormalities of glandular cells are seen, suggestive of adenocarcinoma in situ, adenocarcinoma of the cervix, endometrial adenocarcinoma or adenocarcinoma of an organ outside the uterus.
“Adenocarcinoma" refers to cancers presenting in the inner canal of the cervix (glandular cells).
If your Pap smear is abnormal, your doctor may perform a procedure called ‘colposcopy’. For this procedure your doctor will use a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. It is possible that your doctor also may advise to take a biopsy from any areas that appear abnormal. The biopsy tissue will be analysed by the laboratory for a final diagnosis.
Inadequate
This may be because the cervical sample:
- Was taken but the cervix was not fully visualised.
- Contains insufficient cells.
- Contains an obscuring element (for example, lubricant, inflammation or blood).
If this occurs another sample will be requested.
How often do I need a Pap smear test?
The frequency for repeat screening for average risk, symptom free women is:
- Every three years for women aged 25-29 years.
- Every five years for women 30-65 years.
- Annually for women who are immune-compromised due to disease or medication.
What is the difference between a Pap smear test and HPV?
The HPV test detects the presence of the Human Papillomavirus in your system, which causes cervical cancer. The HPV test on itself will not tell you whether you have cancer.
The Pap smear test identifies abnormalities in the cells and can detect cervical cancer.