Pap smear is the best protection against cervical cancer
The Pap smear is a simple screening test that can find early changes in cells which might become cancer. The Pap test is our best protection against cervical cancer. Deaths from cervical cancer are decreasing, but in women who died of cervical cancer, about 90 per cent had not had regular Pap smears, and more than half had never had a Pap smear at all.
Regular Pap smears recommended for most women
All women between the ages of 18 to 70 years who have ever had sex are advised to have a Pap smear every two years. The most common type of cervical cancer usually takes 10 years to develop, so having a Pap smear every two years is usually enough.
A simple and quick procedure
Named after its inventor Dr George Papanicolau, the Pap smear is a simple and quick procedure that can be done by a doctor or nurse.
During the test, an instrument called a speculum is gently inserted into the vagina to hold the walls of the vagina apart. This allows the cervix (the neck of the womb) to be clearly seen. A small wooden spatula (stick) or a tiny brush is then inserted to collect cells from the cervix. These cells are smeared onto a glass slide which is sent to a laboratory for analysis. The results are usually available within a week. You should arrange to receive the results from your doctor, in person, by phone or mail.
Women's experiences of Pap smears differ, however, many women describe the procedure as uncomfortable, cold, embarrassing and unpleasant, but also quick, simple, necessary and important. If a Pap smear hurts, tell the doctor or nurse straight away.
Different types of Pap smears
Different technologies for collecting and screening cervical cells are now available. For collecting the Pap smear some doctors offer the use of a special scope and use a flow of air to inflate the vagina. New technology has also enabled different laboratory tests, known as ThinPrep and PAPNET, to be used for double checking and re-screening.
These technologies are not used as part of routine screening. You can discuss the availability, costs and advantages and disadvantages of these tests with your doctor or nurse.
Abnormal results do not always mean cancer
If the results of your Pap test show an abnormality, don't panic. An abnormal Pap result doesn't mean you have cancer. Often the cell changes are minor and do not require treatment. Some changes are more significant and may develop into cervical cancer if left, but early detection generally means the changes are easy to treat.
While the Pap smear test is not perfect, it is about 90 per cent accurate in the early detection of changes to the cells of the cervix.
If your Pap smear shows an abnormal result you will be referred for further tests. This may include one or more of the following:
· Another pap smear.
· Colposcopy - this involves a more detailed examination of the cervix using a microscope-like instrument.
· Biopsy - a small sample of skin around the cervix is taken for examination.
Registry promotes better screening
The Victorian Cervical Cytology Registry has been set up to ensure a better screening service for women. The Registry is a confidential list of Victorian women's Pap test results that provides a reminder system for women who are overdue for their next test. The Registry also acts as a safety net for the follow-up of abnormal smears.
Where to get help
· Your doctor
· Your local community health centre
Things to remember
· The Pap test offers our best protection against cervical cancer.
· All women aged from 18 to 70 years should have a Pap smear every two years.
An abnormal result does not mean cancer. Discuss your results with your doctor or nurse.
Pap test abnormalities
All women between the ages of 18 and 70 years, who have ever been sexually active, are advised to have a Pap smear test every two years. Even some women who have had a total hysterectomy (for instance, those with prior cervical cancer) should have Pap smears. This test checks cells of the cervix for any abnormal changes. Of the small number of Pap tests that return an abnormal result, very few are due to cervical cancer. Most abnormalities detected by the Pap test indicate common infections or conditions that either clear up by themselves or respond to simple medical treatment.
Unsatisfactory sample
Sometimes the laboratory will report that the sample was unsatisfactory and another Pap test needs to be taken. This doesn't mean your original Pap test showed abnormalities. Some of the reasons why the initial sample may be unsatisfactory include:
· The slide on which the cells are stored broke
· The cells weren't prepared in the right way in the laboratory
· There were insufficient numbers of cells collected
· The cells were hidden by blood or mucus.
Low-grade abnormalities
Minor changes in the cervix often clear up by themselves, or else require simple medical treatment. Low-grade abnormalities include:
· Atypia
· Non-specific minor changes
· Human papilloma virus (HPV)
· Mild dysplasia - cervical intraepithelial neoplasia grade 1 (CIN1).
· Atypia
Atypia means the cells were not typically normal, but the detected changes were only very slight. The cause is not always obvious from the cell sample. However, inflammation of the cervix causes atypia in the majority of cases. Some of the more common triggers of inflammation include infections, such as thrush. If the underlying cause of the inflammation can't be identified from the Pap test, further tests will be needed. There is no need to have a further Pap test if everything else about the cell sample was normal.
Non-specific minor changes
'Non-specific minor changes' usually refers to signs of irritation, infection or inflammation that were picked up by the Pap test. If the underlying cause of the inflammation can't be identified from the Pap test, further tests will be needed. There is no need to have a further Pap test if everything else about the cell sample was normal.
Human papilloma virus (HPV)
The human papilloma virus (HPV) is a collective name for a group of wart viruses. Some types of HPV are associated with the development of cervical cancer. HPV is asymptomatic, so most women don't know they have the virus until they get the results of their Pap tests. Around eight out of 10 women will have HPV at some stage, and the virus will subside by itself in the majority of cases. For a smaller percentage of infected women, having HPV means an increased risk of cervical cancer. Women with HPV are monitored with more frequent Pap tests, usually every six months, until two normal results are returned.
Mild dysplasia and cervical intraepithelial neoplasia grade 1 (CIN1)
Mild dysplasia and cervical intraepithelial neoplasia grade 1 (CIN1) are two medical terms used to describe the same thing: low-grade abnormal changes in the cells lining the cervix. Mild dysplasia (CIN1) resolves by itself without the need for treatment in around 60 per cent of cases. For the remaining 40 per cent, the abnormalities either remain as they are, or progress to the next stage. Women with these abnormal changes are monitored with more frequent Pap The slide on which the cells are stored broke
· The cells weren't prepared in the right way in the laboratory
· There were insufficient numbers of cells collected
· The cells were hidden by blood or mucus.
Low-grade abnormalities
Minor changes in the cervix often clear up by themselves, or else require simple medical treatment. Low-grade abnormalities include:
· Atypia
· Non-specific minor changes
· Human papilloma virus (HPV)
· Mild dysplasia - cervical intraepithelial neoplasia grade 1 (CIN1).
Atypia
Atypia means the cells were not typically normal, but the detected changes were only very slight. The cause is not always obvious from the cell sample. However, inflammation of the cervix causes atypia in the majority of cases. Some of the more common triggers of inflammation include infections, such as thrush. If the underlying cause of the inflammation can't be identified from the Pap test, further tests will be needed. There is no need to have a further Pap test if everything else about the cell sample was normal.
Non-specific minor changes
'Non-specific minor changes' usually refers to signs of irritation, infection or inflammation that were picked up by the Pap test. If the underlying cause of the inflammation can't be identified from the Pap test, further tests will be needed. There is no need to have a further Pap test if everything else about the cell sample was normal.
Human papilloma virus (HPV)
The human papilloma virus (HPV) is a collective name for a group of wart viruses. Some types of HPV are associated with the development of cervical cancer. HPV is asymptomatic, so most women don't know they have the virus until they get the results of their Pap tests. Around eight out of 10 women will have HPV at some stage, and the virus will subside by itself in the majority of cases. For a smaller percentage of infected women, having HPV means an increased risk of cervical cancer. Women with HPV are monitored with more frequent Pap tests, usually every six months, until two normal results are returned.
Mild dysplasia and cervical intraepithelial neoplasia grade 1 (CIN1)
Mild dysplasia and cervical intraepithelial neoplasia grade 1 (CIN1) are two medical terms used to describe the same thing: low-grade abnormal changes in the cells lining the cervix. Mild dysplasia (CIN1) resolves by itself without the need for treatment in around 60 per cent of cases. For the remaining 40 per cent, the abnormalities either remain as they are, or progress to the next stage. Women with these abnormal changes are monitored with more frequent Pap
