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“Doctor, I can’t remember the last time I had a Pap smear…”
The above is one of the most commonly encountered sentences in my practice. It is not the end of the world, of course, but why do doctors insist that women get regular Pap smears?
The Papanicolaou test, or Pap smear, is a screening method to identify pre-cancerous (indicating the start of cancer) or cancerous cells lurking at the cervix. The cervix is a structure that lies at the top of the vagina and is the gateway to the womb. The test warns us if a woman is at risk of developing cervical cancer or if there are already changes that indicate she is affected.
“I heard from a friend of a friend that it hurts…”
A Pap smear is a pretty simple test. It involves taking a small sample of the surface of the cervix and smearing it on a glass slide. That slide will then be sent to the laboratory to be analysed and results are ready quite quickly. Easy peasy.
However, most women express a fear of the process of itself. Due to the unique location of the cervix, a woman has to lie down for this test. The doctor then positions her, gently inserts a speculum (a specialized tool placed in the vagina to make sure the cervix can be seen clearly) and takes the smear with a brush. Done. Now that doesn’t sound so bad, does it?
Some may experience discomfort during the procedure but there should not be any pain – unless of course you are highly anxious or tense. So keep calm and get your Pap smear done.
“OK, it seems pretty bearable. Sign me up now!”
Well hold your horses! The best time to get a Pap smear would be approximately halfway in between your periods. However, it can be done anytime, as long as it is not during menstruation. If you are no longer menstruating, anytime would be fine.
Many women are uncertain of when to start getting regular Pap smears; most only get them done after childbirth. To set the record straight, any woman who has ever had any sexual intimacy, especially sexual intercourse, should have regular Pap smears done. Even if their periods have stopped, or if they have not had any sexual intimacy for a long time, they should still get it done regularly.
“What is the big hoo-ha about Pap smears anyway?”
As mentioned earlier, this test is used to pick up any signs of changes in the cervix, especially cancerous changes. Cervical cancer is a highly preventable form of cancer, with the condition that women religiously get Pap smears done. In fact, studies have shown that as many as three out of four women who develop cervical cancer have never had a Pap smear or neglected to get it done regularly.
Do bear in mind that an abnormal Pap smear does not equal cancer. Some abnormal results may just indicate an infection that is easily treatable. However, other abnormal results may be more significant and warrant further attention.
Have you heard of HPV? HPV, or human papillomavirus, is a virus so common that four out of five people will have it at some point in their life, often spread via genital contact during sexual activity. Once contracted, our bodies can usually clear itself of this virus within 2 years. However, some of these viruses will insist on overstaying their welcome, and that’s when the trouble starts. This virus can cause changes in the cervix that may lead to cervical cancer. Unfortunately, these changes are usually asymptomatic in the early stages.
The good news is there is a HPV vaccine that can be taken to prevent the virus from having its way in our cervix. However, this vaccine does not prevent cell changes or cervical cancer in women who are already exposed to the virus. So it’s a good idea to get vaccinated before being sexually active. To date, there are only two vaccines currently available and they do not protect against all types of HPV. Therefore, getting yourself vaccinated does not ensure total protection from cervical cancer.
Now, the key phrase here is early detection. A Pap smear allows any changes in the cervix to be detected early, so that further intervention can be done to set things right again. The earlier it is detected, the higher the chances of survival.
So your best bet to get yourself protected from this cancer would be to get your Pap smear done regularly. No excuses!
Dr. Ayu Akida is a Public Health specialist. Her area of interest is family health, especially women’s health and infectious diseases. Find out more about her at The Team page.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]