The Importance of Pap Smears

Despite 30 years of medical advancements and investments in health infrastructure, in some countries, there are still more than 50 women dying from cervical cancer for every 100 women who are diagnosed with the disease (1). Ironically, it is also one of the most preventable cancers today, as it can be avoided by detecting and treating abnormal changes in the cervix early on, often years before cancer develops (2).

 

The Pap (Papanicolaou) test has long been the primary method for early detection.

 

What is Pap Smear?

A pap smear is a procedure in which cells are collected from the cervix for examination (3). The test checks for abnormal cells that are cancerous or have the potential to become cancerous and may also detect certain infections and inflammation (4). The frequency of the test depends on your age and risk factors. However, here is a general guideline:

 

1. For ladies younger than 21 years, taking the test is unnecessary since the risks are low.
2. Ages 21-29, every three years.
3. Ages 30-65 should likely be tested every five years if your Pap test results are normal.
4. Age 65 and older may not be necessary if you’ve never had abnormal cervical cells or cervical cancer and you’ve had three normal Pap test results in a row within the previous ten years.
5. Suppose your test results are abnormal or you are at high risk for cervical cancer. In that case, you may need to be screened more often than the guidelines suggest. It is important, especially if you have a weak immune system or have already been treated for abnormal cervical cells (5,6). 
6. You may need a Pap test more often than once every three years if you have cervical cancer or a Pap test showing precancerous cells, HIV, a weakened immune system from an organ transplant, chemotherapy, or long-term use of corticosteroids.

 

 

Pre-test Preparation Tips

 

For the most accurate Pap smear, it is recommended to take the following steps starting 48 hours before the test:

Refrain from engaging in sexual intercourse or using lubricants

Avoid using sprays or powders near the genital area

Refrain from having any object in the vaginal canal, including tampons, medications, creams, or suppositories

Refrain from raising the area with water, vinegar, or other fluids, including douches (7).

 

Possible Side Effects

 

Unnecessary follow-up Tests and Treatment

 

Finding a condition through screening that would not have caused problems may lead to unnecessary follow-up tests and possibly treatment. The currently recommended screening intervals and tests reduce the chance of finding and treating cell abnormality that would have gone away independently.

 

False-positive Test Results

 

Screening test results may sometimes appear abnormal even though no pre-cancer or cancer is present. That’s why follow-up tests may be necessary (8).

 

Many people experience light bleeding after a Pap smear, which is generally not a cause for concern and typically resolves without additional procedures. However, if you notice heavy bleeding it could indicate an underlying issue, such as infection or another health concern that may require further evaluation.

 

It’s important to monitor your symptoms and consult a healthcare professional if any unusual bleeding occurs.

 

Result Indicatications

 

• A normal or negative result usually means no abnormal changes in the cervix cells.
• Unsatisfactory results may mean there weren’t enough cells in the lab sample, or the cells may have been clumped together or hidden by mucus. Your clinician may suggest scheduling another test in a few months.
• Unclear results may indicate that your cells appear abnormal, though it’s uncertain whether HPV is the cause. In addition, the results could be influenced by factors like pregnancy, menopause, or an infection. An HPV test can help determine if HPV is responsible for the unclear results. Your provider will inform you if additional tests are necessary.
• Abnormal or positive results usually mean that abnormal changes are found in the cervical cells. Most of the time, abnormal results do not mean you have cervical cancer. Minor changes in the cell usually go back to normal on its own. However, your provider may recommend a follow-up test to check. More serious cell changes may turn into cancer if they are not removed. Finding and treating these cells early can help prevent cancer from developing (9).

 

Based on the results, your doctor may suggest a closer examination of your cervical tissue through a colposcopy. During this exam, your provider will use light and magnification to get a clearers view of the vaginal and cervical tissue. In some cases, they may also collect a small sample of cervical tissue in a procedure known as a biopsy.

 

Abnormal cells can be destroyed by freezing, known as cryosurgery, or removed using a cone biopsy or loop electrosurgical excision producer (LEEP). Removing abnormal cells can prevent cervical cancer from ever developing (10). If the biopsy confirms cancer, treatment will depend on other factors, such as stage and tumor grade

 

Precision of Results

Pap tests are highly accurate and are vital for women’s health. Regular screening can lower cervical cancer rates and mortality by at least 80% making them essential for early detection (11). Although the procedure may cause some brief discomfort, it is a minor inconvenience when considering the significant protection, it provides against cervical cancer.

 

Why is Regular Pap Smears Essential?

 

The Pap test plays a crucial role in spotting pre-cancerous or abnormal cells in the cervix long before they can progress to cancer. By identifying these changes early, you can receive appropriate treatment preventing potential complications down the line. Additionally, consistent screening contributes to better management, which leads to improved outcomes and a higher likelihood of successful recovery.

 

Takeaway

 

The significance of regular Pap smear tests can't be overstated. They are instrumental in early detection and intervention. Identifying precancerous or abnormal cells early increases your chance of successfully treating the disease and avoiding complications. It leads to improved health outcomes and a great likelihood of successful recovery. Ensure you take proactive measures to take charge of your well-being for a healthier future.

 

By: Bamlak Agegnehu (RN/BMgt)

 

Edited by: Kateryna Kovalchuk