What is the smear test or Pap test?
The smear test (or Pap test from the Greek doctor that developed it, George Papanicolaou) is the cytological assessment of the cervical surface cell. The cervix is the neck of your womb. This test is designed to detect even small changes on the cervix long before they cause a problem. For most women, the smear test result will be normal (negative).
An abnormal result is also common: approximately 1 in 20 women will get a result from the test other than described as completely normal.
It is very important to remember that it is very uncommon for a lesion detected from a smear test to be cancer. Most of the abnormal smear tests show some minor changes in the cervical cells. This are simply early findings of a lesion that, if left unattended, may cause cancer after many years.
As part of the smear test, a further test may be performed to check for the HPV virus(Human Papilloma Virus). Certain types of HPV can cause changes in the cervical cells.
What is the HPV virus?
Infection from HPV virus is quite common. Most women will be exposed to HPV at some point in their lives. There are many HPV types and some of them (called oncogenic, that is tumor causing) can cause changes in the cervix. In some cases, this changes can, if left untreated, to evolve and cancer may develop. However, not all lesions will evolve into cancer and in many cases, the body can clear out HPV by itself.
HPV is transmitted through sexual contact and does not show nay early symptoms. That means that you or your partner my have been infected many months or even years ago from a previous relationship and without knowing anything about it.
Why should I do the smear test?
Cervical cancer can be prevented. Early signs of lesions can be detected in time and the disease can stop lon before cancer develops. However, unfortunately, each year many women around the world die from cervical cancer. Most of these women had missed doing their yearly screening test. Not having regular smear tests is the most important factor for developing cervical cancer.
Should all women be checked?
We recommend regular smear tests annualy in all women since the time they started having sexual intercourse up to the age of 65. Cervical cancer is more common in women that:
started sexual intercourse at a young age
had many partners or had a partner with many relationships
take immunosupressive drugs (for example after organ transplantation)
Even after menopause, the smear test is needed. Ask us for additional information if you:
had hysterectomy (removal of the womb)
are over 65 years old
had never had sexual intercourse
are unsure if you need to be checked
How is the smear test done?
After emptying your bladder and removing your underwear, you will lie down on the exam chair. If you are wearing a long skirt you do not need to remove it. We will gently introduce a plastic speculum, after being warmed up with water, into your vagina. The speculum helps keeping the vagina open so we can clearly see the cervix. We will then use a thin plastic stick with a small brush at the end to gently scrape some cells from the surface of the cervix, the opening of the cervix and the vagina. The cells that are obtained on the brush are sent away to be examined in the laboratory. The smear test takes about five minutes to be done and the whole examination should not last for more than thirty minutes.
Will I hurt doing the smear test?
You may experience some discomfort or a little pain. This is why you should be relaxed and take slow, deep breaths as pain increases when you are tense. If you fell pain let us know immediately so we can help you!
What is the HPV test?
Some HPV types (mainly the oncogenic type 16 and 18) are the cause of cervical cancer. We can check if there is any viral DNA on the cervix and identify exactly which type is that. Depending on the results, we can decide if further testing is warranted. This sophisticated test is not needed by all women. We will discuss with you the options about the available tests and decide which one is better for you.
When is the best time to have a smear test?
Apart from when you are having your periods, any day will do! However, the best days are after your period has finished until the half of your cycle.
Can I have sexual intercourse before the smear test?
If you use spermicide, a diaphragm or a lubricating gel, do not use them 24 hours before the test. If you have unprotected intercourse, avoid contact 24 hours before the test. Additionally, do not do a vaginal douche.
When will I get the results back?
Results should be ready in two weeks' time. As soon as we have them back, we will call you to book an appointment in order to discuss findingd with you. If the result shows margina or mild changes then we will discuss further with you if there are any benefits from HPV testing. We will also discuss the need for further testing (for example a colposcopy).
How accurate is the smear test?
Early diagnosis and treatment can very effectively protect from developing cervical cancer. No test that is 100% accurate exists and the smear test is no exception. In a few cases, the test will need to be repeated. This is because there might be:
an infection that needs to be treated first.
mucus or blood that can obscure cervical cells.
Insufficent sample for the cytologist to establish diagnosis or some technical error might have happened.
In case some abnormality is found, is there anything that can be done?
Yes. When we have the results back, we will inform you about the findings. We will discuss with you the significance of the results and are the possible consequences for your health. We will also inform you about additional tests that need to be done and explain the benefit of doing them. One of these is called colposcopy. Colposcopy is a test where the cervix is examined under magnification and, after using particular reagents, lesions become apparent. If needed, small biopsies from the cervix can be taken under local anesthesia in the Office. If the findings are very serious, we will then have to remove a small piece of the cervix by surgery but, luckily, this is uncommon.
Can the smear test protect me from cancer?
Yes. Regular gynecological examination and the smear test is the best way yo detect changes in the cervical cell long before cancer happens. Even in the very rare and undesirable case that there is a very serious lesion, early treatment is life- saving.