Pap Smears

What is a Pap smear?
A Pap smear is a test your family doctor does to check for signs of cancer of the cervix. The cervix is part of your uterus (womb). During a Pap smear, your family doctor takes a sample of cells from your cervix to be tested. To take the sample, your family doctor will put a special instrument called a speculum into your vagina. This helps open your vagina so the sample can
be taken. Your family doctor will gently clean your cervix with a cotton swab and then collect a sample of cells with a small brush, a tiny spatula or a cotton swab. This sample is put on a glass slide and sent to a lab to be checked.

What is the sample checked for?
The cells on the slide are checked for signs that they're changing from normal. Cells go through a series of changes before they turn into cancer. A Pap smear can show if your cells are going through these changes long before you have cancer. Cervical cancer is not life-threatening if it's caught early. This is why getting regular Pap smears is so important.

What do the results mean?
A negative Pap smear means that your results are normal. A positive Pap smear means that your results aren't normal. A positive Pap smear can be a sign of a number of changes in the cells on your cervix:

Inflammation (irritation) .
This can be caused by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV) or herpes virus, or many other infections.

Very early signs of cancer.
These changes are called dysplasia. More serious signs of cancer. These changes affect the top layers of the cervix but don't go beyond the cervix. This is called "carcinoma in situ." More advanced cancer.

When should I have Pap smears?
You should have your first Pap smear when you start having sex or by age 18. Continue having a Pap smear once a year until you've had at least 3 normal ones. After this, you should have a Pap smear at least every 3 years, unless your family doctor thinks you need them more often. Keep having Pap smears throughout your life, even after you've gone through menopause.
Certain things put you at higher risk of cervical cancer. Your family doctor will consider these when recommending how often you should have a Pap smear. If you're older than 65, talk with your family doctor about how often you need a Pap smear. If you've been having Pap smears regularly and they've been negative, you may not need to keep having them.

How reliable is the test?
No test is perfect, but the Pap smear is a reliable test. It has helped drastically lower the number of women who die of cervical cancer. Sometimes the test may need to be redone because there were not enough cells on the slide. The lab will tell your family doctor if this happens. ThinPrep, PAPNET and FocalPoint are ways to make Pap smears more accurate. ThinPrep is a way of preparing the sample of cells that makes it easier to spot abnormalities. PAPNET and FocalPoint are computer systems that help lab technicians find abnormal cells. These options may not be available in all areas, and they may increase the cost of a Pap smear.

What should I do before the test?
Plan to have your test done at a time when you aren't having your menstrual period. Don't douche, use a feminine deodorant or have sex for 24 hours before the test.

What happens if I have a positive Pap smear?
If the results of your Pap smear are positive, your family doctor may want to do another Pap smear or may want you to have a colposcopy. A colposcopy gives your family doctor a better look at your cervix and allows him or her to take a sample of tissue (called a biopsy). Your family doctor will use an instrument called a colposcope to shine a light on your cervix and magnify it. Your family doctor will explain the results and discuss treatment options with you.

What puts me at risk of cervical cancer?
Risk factors for cervical cancer:

• Starting to have sex early (before age 20)
• Having had many sexual partners
• Being infected with an STD or having had a sex partner who has an STD
• Smoking
• Using birth control pills and/or giving birth to many children when also infected with HPV
  

The main risk factors for cervical cancer are related to sexual practices. Sexually transmitted diseases (STDs) may make your cells more likely to undergo changes that can lead to cancer. STDs include HPV, herpes, gonorrhea and chlamydia. HPV is the virus that can cause genital warts. It seems to be very closely connected with these changes.

Is there anything I can do to avoid getting cervical cancer?
You may be able to reduce your risk of cervical cancer if you:

• Delay sexual intercourse until you're 20 years of age or older.
• Have only 1 sex partner who doesn't have an STD and is only having sex with you.
• Limit your number of sex partners.
• Always use latex condoms (rubbers) to protect against sexually transmitted diseases (STDs). (Remember condoms aren't 100% effective.)
• Avoid smoking.

(AAFP)