Pap Smear (Cervical Smear)
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What is a Pap smear?
A Pap smear is a test your health care provider does to check for signs of cancer of the cervix. The cervix is the lower part of your uterus (womb).
During a Pap smear, your health care provider will put a special instrument called a speculum into your vagina. This helps open your vagina so the health care provider can see your cervix and take a sample. Your health care provider will gently clean your cervix with a cotton swab and then collect a sample of cells with a small brush, a tiny spatula or a cotton swab. Your health care provider will put this sample on a glass slide and send it to a lab to be checked under a microscope.
Taking a sample of cells
What is the sample checked for?
The cells from your cervix are checked for signs that they’re changing from normal cells to abnormal cells. Before they turn into cancer, cells go through a series of changes. The results of your Pap smear can show whether your cells are going through these changes long before you actually have cancer. If caught and treated early, cervical cancer is not life threatening. This is why it is so important that you get regular Pap smears.
What do the results mean?
A normal Pap smear means that all the cells in your cervix are normal and healthy. An abnormal Pap smear can be a sign of a number of changes in the cells on your cervix, including:
- Inflammation (irritation). This can be caused by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV) the herpes virus or many other infections.
- Abnormal cells. These changes are called cervical dysplasia. The cells are not cancer cells, but may be precancerous (which means they could eventually turn into cancer).
- More serious signs of cancer. These changes affect the top layers of the cervix but don’t go beyond the cervix.
- More advanced cancer.
How often should I have a Pap smear?
Routine Pap testing of sexually active women should start at age 21. For women who become sexually active after age 21, screening should start within three years of their first sexual encounter. Certain things put you at higher risk of cervical cancer. Your health care provider will consider these when recommending how often you should have a Pap smear.
Unless your health care provider suggests that you need one more often, you should have a Pap smear every 1-3 years beginning at 21 years of age and continuing until 65-69 years of age (recommendations may vary depending on province, discuss your situation with your health care provider) If you’re older than 69 years of age, talk with your health care provider about how often you need a Pap smear. If you’ve been having Pap smears regularly and they’ve been normal, you may not need to keep having them.
If you’ve had a hysterectomy with removal of your cervix, talk with your health care provider about how often you need a Pap smear.
If you’ve never had a high-grade precancerous lesion or cervical cancer, ask your health care provider how often you need a Pap smear.
How reliable is the test?
No test is perfect, but the Pap smear is a reliable test. It has helped drastically lower the number of women who die of cervical cancer.
Sometimes the test may need to be redone because there were not enough cells on the slide. The lab will tell your health care provider if this happens.
What should I do before the test?
Plan to have your test done at a time when you aren’t having your menstrual period. Don’t douche, use a feminine deodorant or have sex for 24 hours before the test.
What happens if my Pap smear is abnormal?
If the results of your Pap smear are abnormal, your health care provider may want to do another Pap smear or may want you to have a colposcopy.
A colposcopy gives your health care provider a better look at your cervix and allows them to take a sample of tissue (called a biopsy). Your health care provider will use an instrument called a colposcope to shine a light on your cervix and magnify it. Your health care provider will explain the results and discuss treatment options with you.
What puts me at risk for cervical cancer?
Risk factors for cervical cancer:
- Starting to have sex early
- Younger than 17 years at first full-term pregnancy
- Having had many sexual partners
- Being infected with a sexually transmitted infection (STI) or having had a sex partner who has an STI
- Smoking
- Intrauterine device (IUD)
- Poverty
- Overweight
- Women whose mothers used Diethylstilbestrol (DES) while pregnant with them
- Multiple full-term pregnancies
- Family history
- Diet low in fruits and vegetables
The main risk factors for cervical cancer are related to sexual practices. Sexually transmitted infections (STIs) may make your cells more likely to undergo changes that can lead to cancer. STIs include HPV, herpes, gonorrhea and chlamydia. HPV is the virus that can cause genital warts. It seems to be very closely connected with these changes.
Is there anything I can do to avoid getting cervical cancer?
You may be able to reduce your risk of cervical cancer if you:
- Delay sexual intercourse until you’re 18 years of age or older.
- Make sure both you and your partner are tested for sexually transmitted infection (STIs).
- Limit your number of sex partners.
- Always use latex condoms to protect against STIs. (Remember condoms aren’t 100% effective.)
- Avoid smoking.
- Eat a balanced diet.
- Maintain a normal weight.
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