A Pap smear is a quick and simple test in which a number of cells are collected from your cervix and sent to a laboratory where they are tested for detection of abnormal changes. No drugs or anaesthetics are required and the test only takes a few minutes.
Dr Sean Burnet from Specialist Clinics of Australia in Sydney recently spoke about the importance of pap smears at an event held during World Gynaecology Awareness Day. “Some women put off having their regular Pap Smear, or simply forget about it. However, what is important to remember is that having this simple test can prevent a very serious condition. We all know prevention is the best approach when it comes to cancer,” said Dr Burnet.
The significance of Pap smear
Pap smear tests are a very important part of a woman’s health. Since the introduction of this type of screening, the rates of cervical cancer have dropped significantly.
Fact: The majority of women diagnosed with cervical cancer have not had regular Pap smears.
Current NSW Health guidelines recommend that women aged between 18 and 69 years should have Pap tests every 2 years, even if they had the cervical cancer vaccine. “Screening for cervical cancer has greatly reduced the rates of this type of cancer not only in Australia, but also around the world,” Dr Burnet reported.
While cervical cancer used to be the 8th most common cancer in women, the introduction of Pap smear managed to bring this rate down to the 18th most common cancer in women.
What does a cervical cancer screening involve?
A cervical cancer screening usually consists of a Pap test (also called a “Pap smear” or “cervical cytology”). In some women, a test for Human Papilloma Virus (HPV) is also performed, as it is the virus that can cause cervical cancer. Women who are found to have abnormal cells in the cervix require further follow-up analysis or even treatment, as the pre-cancerous cells can persist and develop into cancer.
The outer surface of the cervix is covered in squamous cells. A precancerous lesion affecting these cells is called CIN. These changes are categorised as being mild (CIN 1) or moderate to severe (CIN 2 or 3). The canal of the cervix is lined with glandular cells. A precancerous lesion affecting these cells is called AIS.
Precancerous lesions are diagnosed using a cervical biopsy or endocervical curettage (ECC), usually during a colposcopy procedure.
Low-grade squamous lesions, also referred to as cervical intraepithelial neoplasia (CIN 1), usually resolve without needing a treatment. However, it is very important to ensure a follow-up procedure that can establish whether the cells progressed to high-grade lesions or cancer.
What causes cervical cancer?
“A long-term infection with the HPV virus is generally the cause of almost all cervical cancers. HPV is a virus and the majority of abnormal Pap smear results are caused by HPV,” cautioned Dr Burnet.
Fact: Anyone who has ever had sex can have HPV.
This virus is so common that 4 out of 5 people will have had HPV at some time in their lives. Although in most cases the virus clears up by itself in 1-2 years, if left undetected, it can persist and develop into cervical cancer, a process that usually lasts about 10 years.
“A Pap smear performed every 2 years can detect any abnormal cell changes caused by HPV, which can then be monitored and treated to prevent cancer,” explained Dr Burnet. “While HPV is very common, most women with HPV will not develop cervical cancer.”
Early protection against cervical cancer
In Australia, a vaccine that can prevent infection with the types of HPV that cause most cases of cervical cancer is available to women aged between 9 and 26 years old.
Free HPV vaccine is available under the National Immunisation Program. The vaccine aims to prevent cervical cancer in future generations of women and it is best administered to young people before they start having sex.
At Specialist Clinics of Australia, we were able to assist many women in successful cervical cancer detection and based on his experience, Dr Burnet firmly believes that regular Pap smears are essential, as the HPV vaccine does not protect against all the HPV types that can cause cervical cancer.
What is colposcopy?
Colposcopy is a diagnostic procedure in which a colposcope (type of a microscope) is used to provide an illuminated and magnified view of the cervix, vagina, and vulva. The colposcope does not enter the vagina but looks through the speculum to view the cervix.
Indications for colposcopy:
- Abnormal Pap smear result
- Abnormal vaginal bleeding (such as bleeding after intercourse or post coital bleeding)
- Abnormality is seen on the cervix vagina or vulval area during examination
During the colposcopy procedure, if any areas of the cervix look abnormal, a biopsy is taken. A biopsy involves extracting a small sample of the affected tissue and women often feel some pain or a slight pinch with this procedure. Once this is done, the tissue sample is sent over to a laboratory for further testing.
Your gynaecologist will explain the results of the colposcopy during your appointment. A follow-up visit is necessary, as it takes time for the biopsy to return from the laboratory.
“Although a Pap smear is an uncomfortable procedure,” said Dr Burnet, “it is the most reliable method of protecting women against cervical cancer. Do not be discouraged. It takes only a few minutes to have it done, and the protection it offers is invaluable!”