Short for Papanicolaou Test and named after its creator Georgios Papanikolaou, the Pap smear was developed in the 1940s as a way to screen for cervical cancer and its precursors. The Pap smear does not test for STIs.
The World Health Organization ranks cervical cancer as the fourth most frequent cancer among women globally, with an estimate of 570,000 new cases in 2018 alone. According to the HPV Centre, cervical cancer is the second leading cancer type among women in the Philippines, with almost 7,200 new cases diagnosed each year and an average of 4,088 deaths annually.
What do these scary statistics have to do with the Pap? The Pap smear is the leading screening practice to prevent and catch cervical cancer, and its implementation has caused a significant decline in cervical cancer cases in countries with good screening practices. For example, The National Cancer Institute in the US has reported that regular Pap tests decrease cervical cancer rates and mortality by at least 80%!
Pap tests are so effective because regular testing can provide early detection of abnormal cells before they have a chance to become cancerous.
So if you possess a vagina and are at least 21 years old, you should definitely have a Pap smear done every 3 years³. You can schedule your Pap smear as part of your annual check-up with your obstetrician-gynecologist (OB/GYN) or as a separate appointment.
The process is pretty straightforward: the patient leans back on the examination table, legs supported in stirrups, and a metal/plastic device called a speculum is inserted into their vagina. This device allows the doctor to see what they’re doing. Then, either a small spatula or tiny tool called a cytobrush is used to gently take a sample of cells from the patient’s cervix. The main (but not only) known culprit of cervical cancer is HPV¹, so an additional swab may also be taken for an HPV test².
The Pap smear only takes around 15 minutes to do. You can expect the speculum to be cold and a bit uncomfortable as it’s put into position, and to feel some pressure on your cervix when the swabs are being taken. You may also experience a bit of spotting afterward, so pack a liner or pad with you to your appointment.
While you can sometimes have the test done while on your period, it is best to wait until you’re not menstruating. Also make sure not to have sex, use spermicidal products, lubricant, or tampons, or douche for 48 hours before the test.
Make sure to ask your doctor when you can expect the results. If you don’t hear anything back in that time, feel free to follow up!
Step One: DON’T PANIC. Inconclusive or abnormal test results don’t automatically mean cancer. What they do mean is that further testing is needed. Your doctor may order a second Pap smear, an HPV test, or a colposcopy.
As touched on earlier, an HPV test is done the same way as a Pap. During a colposcopy, a speculum will be inserted into your vagina and a vinegar-like solution will be used to wash your cervix (this makes it easier to see any potentially abnormal tissue). The doctor will then use a magnifying tool called a colposcope to take a closer look at your cervix. Unlike a speculum, the colposcope, which resembles a pair of binoculars, will not be inserted into your vagina.
If the doctor thinks anything looks suspect, they may do a biopsy, meaning a small sample of abnormal-looking tissue will be taken from your cervix. Depending on the results of the biopsy, you may need additional tests or treatment. It’s also possible for the biopsy itself to be the treatment if the doctor was able to take out all the abnormal cells in the process.
If a biopsy is done, you can expect a bit of a pinching or cramping sensation and some spotting for a few days after the procedure.
Even though the Pap smear is a quick, simple, and virtually painless procedure, many women still finding it daunting. And who can blame us? At the very least, physically getting into such an exposed position can feel awkward, even for women who have been to an OB/GYN before. Additionally, the idea of possibly being diagnosed with cancer or finding abnormal cells is a really frightening one.
To help combat any misgivings, here is a small pep talk on the Pap: This super quick test is a proven example that an ounce of prevention being worth a pound of care. Don’t let awkwardness or fear keep you from taking care of yourself and your body. Your and your health are important, and that body of yours is the only one you’ve got!
If you’re still not 100% on board, your doctor is there to answer any questions and squelch any fears you may have about getting tested. Don’t have a trusted doctor? Here are some resources to help fix that.
¹HPV, or Human Papillomavirus, is an STD spread through vaginal, anal, and oral sex, and can be passed to a partner even if the person infected doesn’t have any symptoms. There are over 100 strains of HPV and two of them, HPV 16 and 18, are together thought to be responsible for roughly 70% of all cervical cancer. HPV has also been linked anal and oropharyngeal cancers in women and men, as well as penile cancer in men.
²The HPV test specifically checks for high-risk strains such as HPV 16 and 18.
³Some people may need more frequent testing, such as immunocompromised individuals or those who’ve had issues with their cervix before. Your healthcare provider will let you know if a schedule different from the 3-year norm is necessary.
January 24, 2020