The Papanicolaou test, commonly referred to as the pap test is a pelvic examination that enables medical practitioners to screen for cervical cancer in women. There is a lot of uncertainty around the subject, and this directly results in more women shying away from cervical cancer screening, hence, the need to demystify the pap test, ensuring you have sufficient information you need for you to go into a pap smear test with confidence.
When is it time to begin taking the tests?
It is best recommended to have a session with your doctor or gynaecologist, before deciding on when you want to get started, especially if you have had a myriad of reproductive or excretory health issues. Generally, doctors around the world recommend pap tests for women aged between 21 years and 65 years, at least once every three years. There are, however, various risk factors that may predispose one to more frequent testing. These include a long history of smoking, being HIV positive, weakened immunity due to previous organ transplants or having gotten a positive diagnosis for cancer before. If sexually active with multiple partners, your doctor may recommend more frequent pap testing.
What entails a pap smear procedure?
A pap smear test can at best cause you discomfort as the procedure continues, worse still, result in pain or mental torture. The latter could be because of a general feeling of invasion of privacy and for others, a case of fear of the whole process of pelvic penetration.
A pap smear basically entails sampling and testing cells from your cervix- lower, narrow end of the uterus right above your vagina. Prior to the scheduled date of the test, it is advised not to have it done during the menstrual cycle, not to have any form of intercourse a few days before and not to use any form of vaginal medication (prescribed or otherwise).
This is because a bleeding or clogged uterus may interfere with the accuracy of the results. One may also need to pee a few minutes before the test as having it done on a full bladder could add to the discomfort of the procedure.
You will be requested to lie down on your back, on a doctor’s examination table with the knees bent. Your legs will be rested on supports called stirrups.
An instrument known as a speculum is what the doctor uses for the pap smear. The speculum is gently inserted into the vagina, where it is carefully placed to hold the vaginal walls apart, for easy and clear visibility of the cervix. This insertion process may cause a lot of pelvic pressure-depending on the woman’s body- hence the discomfort that comes with the pap smear procedure.
This is when the doctor samples cervical cells using a soft brush and spatula. These are then transferred into sample preservation containers depending on whether the pap test you are undergoing is a liquid-based pap test or a conventional pap smear.
What changes can be detected on the smear?
Inflammation or infection– this is common especially among sexually active women. This is because the inner lining of the cervix is frequently exposed to external factors, looking bright red, a common tell for inflammation. This also results in the endocervix self-lubricating by releasing a discharge. If this discharge is colored or manifesting an odor, then that may be indicative of an infection. It may also occur because of frequent tampon usage which often dry up vaginal walls making it more susceptible to infections.
Atypical cells– this is when the examiner notices the presence of peculiar cells with peculiar functions but do not necessarily indicate abnormality. This could have one of two outcomes, favoring dysplasia, or the cells reported as of unknown significance. In the latter case, the test will be ruled out as uncertain, and a new one will be recommended after six months.
Dysplasia is the presence of abnormal cells within a tissue that may indicate a pre-cancerous stage. When this is the case, the doctor who performed the pap test will refer you to a cervical cancer expert for treatment.
Where dysplasia is the case, the atypical cells may vary from HPV-CIN1-CIN2-CIN3-CIN3(Glandular extension) which we will discuss extensively in the next blog. These atypical cells are known to suddenly disappear hence the need for frequent consultations with your doctor or gynecologist in between pap smear tests.
We encourage you to become more conscious, more consultative and to keep educating yourself on the risk factors, preventive and nutritional support information, as we strive to beat cervical cancer together.
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