Pap Smears and Cervical Cancer

Eating a well balanced diet and exercising are very important for creating a healthy lifestyle. However, an important part of  being healthy and looking after yourself also means participating in screening programmes for important diseases, such as cancer.

In this article, we will focus on Cervical Cancer and the screening test for it, the Pap smear. 

Cervical Cancer is a cancer that arises from the cervix, which is the lower part of the uterus or womb, at the top of the vagina. It is due to abnormal changes in the cells in this area and can spread to other parts of the body.

In most cases, cervical cancer occurs in women who have been infected with the Human Papillomavirus (HPV). HPV is spread through sexual intercourse and any type of sexual activity. There are many types of HPV and at least 14 types are considered to increase a woman’s risk for cervical cancer.2 Most types do not cause any symptoms.

Smoking also increases the risk of developing cervical cancer. 

After infection with HPV, cervical cancer can take many years to develop, but before this, the cells in the cervix can start to show changes. These are called pre-cancerous changes, which means that in the future, cancer can develop.

This is the point in time that doctors and nurses want to catch, before cancer develops, because the earlier that it is found, the earlier treatment can be started and the more successful the treatment will be and will give you a greater chance of cure.   So using a Pap smear to find these abnormal cells is a major step in preventing cervical cancer.

Generally, Pap smear screening is started at age 21 years, although it can be started at a younger age if necessary. Once results are negative for abnormal cells, it is performed every three years until the age of 65 years.

It is never too late to start even if you have never done one and you are over 21, or over 65, the test can and should still be done.

To prepare for a Pap smear, you need to make sure that the test is taken under the best possible conditions, so that the results are as accurate as possible. You should try to:

  • Avoid sexual activity for at least two days before taking the test. You should also avoid douching, using any vaginal medications, creams or jellies before doing the test because it may hide the abnormal cells.
  • Avoid doing the test during your period, so try to book your test for a time when your cycle has finished.

Usually, a Pap smear is performed in the doctor’s or nurse’s office. At the office, you will be asked to remove any skirt, pants and underwear. You will then be asked to lie down on an examination table and  be covered from the waist down. The doctor or nurse will ask you to bend your knees and place your heels in stirrups attached to the table.

A speculum will then be inserted gently into your vagina and opened, so that the cervix can be seen. This usually causes a feeling of pressure, so it is a good idea to empty your bladder first!

The doctor or nurse will then use a soft brush and a spatula to take samples of the cells from the cervix. This usually does not hurt and takes only about 1-2 minutes to perform. The cells are put on a glass slide and sent to the laboratory.

The results can take about one (1) month to six (6) weeks to receive. If no abnormal cells are found, you will be told that the result is negative and you will not need any more testing or treatment.

If abnormal cells are found, then you will be told that the result is positive. But positive does not mean that you have cancer. It can mean that there are just some few, unusual cells or that there are pre-cancerous changes. Some of these changes just mean that a Pap smear test should be repeated, or it can mean that further testing will be needed. Your doctor will explain what the result means and what is the next best course of action.

You can get a Pap smear in any of the health centres in the North West Regional Health Authority (N.W.R.H.A.) and you can book your appointment  by calling your local health centre on the listed numbers available here at http://www.nwrha.co.tt/facilities-and-services/categories/health-centres

Mobile clinics that offer pap smears are available in different communities and marketplaces during the month and you can check the schedule here  http://www.nwrha.co.tt

References:

  1. Mayo Clinic. Pap Smear [Internet].1998-2019 Mayo Foundation for Medical Education and Research (MFMER); 2018 Sep 18 [cited 2019 Jul 02]. Available from: https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841
  1. World Health Organisation. Human papillomavirus (HPV) and cervical cancer [Internet]. 2019 [cited 2019 Jul 02]. Available from https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer
Published in NWRHA Service