Despite the many advances in medicine and improved treatments women still die from cancer of the cervix. Detecting changes in the cells of the cervix, that suggest cancer may develop in the future, has resulted in many women being able to prevent cancer of the cervix. Cancer of the cervix is now considered a preventable cancer.
Who gets cervical cancer?
It is possible for women of all ages to develop cervical cancer, although the condition mainly affects sexually active women aged 30 to 45 and older. The condition is very rare in women under 25. Cervical cancer is still a leading cause of death for women living in Anguilla.
What is a Pap smear?
A Pap smear, also called a Pap test or cervical screening test, is a procedure to test for pre-cancerous lesions in women. A Pap smear involves collecting cells from the cervix — the lower, narrow end of the uterus (womb). Detecting abnormal cells early with a Pap smear is the first step in halting the possible development of cervical cancer. All experts in this field agree that detecting and removing abnormal cervical cells can prevent cervical cancer.
The Pap smear is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer in some women.
The Pap smear is a screening test. If abnormal, other investigations are often needed.
Who should have a Pap smear?
A woman and her doctor can decide when it is time for her to begin Pap testing and how often she should have the test. In general, doctors recommend beginning Pap testing at age 21. All sexually active women should have regular Pap smears. Most doctors stop doing Pap smears after the age of 70 if all previous tests were negative.
How often should Pap smear be repeated?
If you have certain risk factors, your doctor may recommend more-frequent Pap smears regardless of your age. These risk factors include:
• A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
• Exposure to diethylstilbestrol (DES) before birth
• HIV infection
• Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use.
The woman and her doctor can discuss the benefits and risks of Pap smears, and doctors generally recommend repeating Pap testing every 3 years for women ages 21-65.
Women age 30 and older can consider Pap testing every 5 years if the procedure is combined with testing for HPV.
Where is Pap smears done
Pap smears are often done in the doctor’s office or in a clinic. You do not have to go to a hospital to have this screening test. Do not go to the Accident and Emergency room for a Pap test either. The trained person performing the Pap test will take samples of cervical cells using a soft brush and then send them for testing. The cells are examined under a microscope to look for characteristics in the cells that indicate cancer or a precancerous condition.
Results
There are several ways of reporting the results of the Pap smear. If only normal cervical cells were discovered during your Pap smear, you are said to have a negative result. You would not need any further treatment or testing until you are due for your next Pap smear and pelvic exam.
If abnormal or unusual cells were discovered during your Pap smear, you are said to have a positive result. A positive result does not mean you have cervical cancer. What a positive result means depends on the type of cells discovered in your test. Your gynaecologist is the best person to interpret these results for you and guide you to further investigations if required.
If your Pap smear is abnormal, your gynaecologist may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva.
Your gynaecologist may also may take a tissue sample (biopsy) from any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis is made.
What is a false negative Pap smear test?
A Pap test is a safe and reliable screening test but, in a few cases, it might not give the correct result. It is possible to receive false-negative results. This means that your Pap test indicates no abnormality, even though you do have abnormal cells.
A false-negative result does not mean that a mistake was made. Factors that can cause a false-negative result include:
• An inadequate collection of cells
• A small number of abnormal cells
• Blood or inflammatory cells obscuring the abnormal cells
Although it is possible for abnormal cells to go undetected, time is on your side. Cervical cancer takes several years to develop. Hence the importance of regular testing. If one test does not detect the abnormal cells, the next test most likely will.
Conclusion
A Pap smear is a screening test for cancer of the cervix. This is a simple and reliable test that has been proven to prevent cervical cancer. Cancer of the cervix is now considered a preventable cancer and women having regular Pap smears have been shown to less likely to die from cervical cancer. If you are over 21 and have not had a Pap smear talk to your healthcare provider today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
