It is a screening test for cervical cancer in women. It involves taking a sample from the mouth of the uterus, that is, the cervix seen at the top of the vagina. It is a procedure to gently remove cells from the surface of the cervix and the area around it, which are further examined under a microscope for cell changes indicative of pre-cancerous or cancerous stages of the cervix. It can also detect inflammation or infections like yeast, trichomoniasis, etc. It is also called the pap test or Papanicolaou test.
This test is done to screen for cervical cancer. It is the 3rd most common cancer in women and the second leading cause of death in women. It accounts for 6 to 29% of all cancers in women. It is estimated that cervical cancer will occur in 1 in 53 Indian women during their lifetime. India has reported 5-year survival rate for cervical cancer is around 46%. Screening for cervical cancer is helpful in decreasing mortality by early diagnosis and treatment.
Long-lasting infection with certain types of Human Papillomavirus is responsible for 90% of cervical cancer. It is a sexually transmitted infection.
Once you are sexually active, doctors recommend beginning PAP testing at the age of 21. It should be done even if one has taken a cervical cancer vaccine.
How Often Should a Pap Smear be Repeated?
It is generally recommended that women between 21 and 65 get it done once every 3 years. If the test is combined with HPV [Human Papilloma Virus] testing, women aged 30 or older can consider getting it done every 5 years. After 65, a Pap smear may not be necessary if the previous tests were normal.
Depending on your risk factors and reports, the doctor may advise you to take more frequent tests like:
Yes, it is safe to take the test in pregnancy. This is perfectly safe for you and the baby. It does not lead to miscarriage. It is a routine part of prenatal care. In case of an abnormal test report, either you have advised treatment safe in pregnancy, or it is deferred until you deliver the baby.
It's better to wait for 12 weeks post-delivery to have the test.
It is done in the OPD clinic along with your internal vaginal examination, where the doctor inserts an instrument called a speculum inside your vagina, visualises your cervix, and takes a sample using a soft brush. This sample is then sent to the lab for examination. This takes only a few minutes.
No, it isn't. Just a little discomfort and a bit of pressure can be felt. The test can be more comfortable if you relax the muscles in that area.
There are no restrictions after the PAP smear test. You can continue with your routine lifestyle. It is quite common for one to have slight bleeding/spotting for a few hours to 2 days. One must contact the gynaecologist if the bleeding is heavy or doesn’t stop after three days. It is better not to have sexual intercourse or use a tampon if one has bleeding post-pap test.
Yes, you can.
It usually takes 5 to 7 days for the report to come.
The report may come as normal, abnormal, unclear or unsatisfactory.
If the report is negative or normal, it means you do not have any cell changes or pre-cancerous or cancerous cells, and you can resume your testing as told by your gynaecologist. Mostly once in 3 years if only a Pap test was done or once in five years if a Pap test was combined with an HPV test as well.
If the report is abnormal, it doesn’t mean that one has cervical cancer. It means abnormal cells are found in the report. These changes are likely caused by HPV. These changes may be minor or major, categorised as low grade or high grade. Depending on your report, your gynaecologist might recommend more frequent PAP smear tests, further tests, and procedures like a colposcopy or a biopsy.
An unclear report means that the lab couldn't decide if they are normal or abnormal cells. It can be due to pregnancy, menopause or infection. In such a scenario one is usually asked to repeat the Pap test either immediately or after 6 months. An unsatisfactory report means more cells need to be seen in the sample. In this scenario, one will be asked to repeat the sample.
Pap smear is a very easily accessible test that can help in the early diagnosis and treatment of cervical cancer, making the prognosis and five-year survival rate far better for women.
Cervical cancer, when it presents itself with some symptoms, is usually at a late stage. So, one shouldn’t think that if one doesn’t have any gynaecological problems or symptoms, then one doesn’t need to get tested. Even without any problems, one should get the Pap smear test done on time according to the guidelines. One small step can help you get a much better quality of life. For all other Pap smear related queries, book an appointment today and meet your gynaecologist.
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