What is the Procedure for a PAP smear?

Cancer of cervix (mouth of the uterus) is one of the leading causes of death and disease in women worldwide. Good thing is that cancer cervix takes many years to develop and it is very easy to screen the cervix. It stays in a precancerous form in the cells of the uterus for many years. It is at this stage that screening is useful as it detects abnormal cells in the precancerous stage and hence treatment is much easier and complete cure is possible. If detected at a later stage, it becomes very difficult to treat it. PAP test is a quick, easy and painless procedure to screen the cervix.

Dont’s to be kept in mind for a Pap Smear:

• Not done during menstruation
• No intercourse 48 hours prior to test
• No douches, vaginal medication, vaginal foams, creams or jellies 48 hours before the test

The Pap Smear Procedure:

• The woman lies on the examination table on her back with legs apart
• Doctor will clean your vagina with normal saline
• Then a speculum is inserted into the vagina to open the walls so that cervix can be seen clearly
• You may feel pressure sensation in your vagina
• The cervix is then scraped using a wooden spatula or small plastic broom and cells are obtained
• In conventional smear, the cells are evenly applied on a glass slide and sprayed with a fixative
• This slide is sent to the laboratory for examination under microscope
• In liquid PAP or a thin prep test, the sample is rinsed into a vial and send to the laboratory for slide preparation and examination. The liquid test is better than slide because the cell shape is preserved better in the liquid test. Cost of the liquid test is higher than the conventional one.

In the laboratory, the cells are looked at under the microscope under magnification to see for any cell changes. There could be inflammatory changes or dysplastic changes or infection with HPV( human papillomavirus )

If it is abnormal then a wait and watch approach is used to see whether the changes clear up or not. Majority of the changes clear up on their own but if they don’t then a procedure called colposcopy is done, if needed biopsy is also done.

At what age should I go for a Pap Smear Test?

It starts at age 21 years if the lady is sexually active. It is repeated every three years from 21 to 65 years. If after 30 years, HPV co-testing is done along with PAP you need to repeat it after 5 years if it is normal.

Get vaccinated for HPV, it protects against viral warts and cancer cervix. Even if you are vaccinated, screening continues as such in a similar fashion.

Women usually think that PAP test is painful and unnecessary and don’t do it but with so much of medical advancement, you should take care of your health and get all your tests including PAP regularly so that optimal health is maintained and timely treatment is given.