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Pap Smear

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Pap Smear
Summary
  • Pap Smears are used to detect changes in the cells of the cervix, which may lead to cervical cancer if untreated.
  • Pap Smears can detect up to 90% of these changes.
  • The majority of women who develop cervical cancer have never had a Pap Smear, or haven't had one for more than 10 years.
Description

A Pap Smear is a test where a sample of cells is collected from around the cervix (the small opening between the uterus and the vagina) and smeared onto a glass slide.1 This smear is then examined under a microscope for any abnormalities. The Pap smear is named after its founder, Dr Papanicolaou.

Pap Smears are used to detect changes in the cells of the cervix, which may lead to cervical cancer if untreated. Cervical cancer is very slow to develop. Changes occurring in the cervical cells, which are not yet cancerous, are called pre-cancerous cells, cervical intraepithelial neoplasia (CIN), or cervical dysplasia. Pap Smears can detect up to 90% of these changes. The cervix can then be treated to remove the affected cells, making cervical cancer one of the most preventable of all cancers.2 The majority of women who develop cervical cancer have never had a Pap Smear, or haven't had one for more than 10 years.3

 

Who should have a Pap Smear?

  • All women who have ever been sexually active, including women with only one partner, and those who no longer have sex.
  • Women after menopause.
  • Women who have had a hysterectomy may still need a Pap Smear if the cervix was not removed. Discuss this with your Doctor.
 

How is it done?

All General Practitioners and some Specialist Nurses can perform Pap Smears.

  1. The woman lies on her back with her knees drawn up and apart.
  2. An instrument called a speculum is inserted into the vagina. This holds the walls of the vagina apart and enables the Doctor or Nurse to see the cervix. This may cause some discomfort, but should not be painful. Most pain is experienced when the woman is nervous and tenses the vaginal muscles.
  3. Some cells are gently taken from around the cervix using a small spatula or brush. The cervix itself has few pain receptors, so this usually cannot be felt.
  4. The cells are smeared on to a glass slide, which is then sent to the laboratory for testing.
  5.  Some doctors will also perform a full pelvic examination, to check the size and position of the ovaries and uterus.
  6. The procedure is done in the Doctor's office, and takes about 10 minutes from start to finish.


What about the results?

The results of the Pap Smear test take a few days. Your Doctor will let you know when to telephone for the results.


What if my Smear is abnormal?

If you have an abnormal Pap Smear, DO NOT PANIC. Most abnormal Smears are NOT cancer. Depending on the results, your Doctor may choose to repeat the Smear again in a few months, or may refer you to a Gynaecologist for further assessment. See the Cervical Dysplasia topic on the Healthpoint for further information.

  • Notes

    Pap Smears are not 100% accurate, and occasionally a false-negative result may occur. In women who have regular smears, this is not usually a problem, as any abnormalities will be picked up at the next test, before anything serious has developed. If your Doctor is concerned about the accuracy of the results, the test can be repeated in a few weeks or months. Menstruation, recent intercourse and vaginal infections such as thrush can all affect the accuracy of a Pap Smear. Ask your Doctor when the best time for your Pap Smear is.


    References

    1. Dirckx J (ed.) Stedmans concise medical and allied health dictionary (3rd ed). Baltimore: Williams & Williams; 1997
    2. Beers M et al (eds). The Merck Manual of diagnosis and therapy (17th ed). New Jersey: Merck Research laboratories; 1999
    3. Beers M et al (eds). The Merck Manual of diagnosis and therapy (17th ed). New Jersey: Merck Research laboratories; 1999
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