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Pap Smear: Facts you Should Know.
According to a recent news (Oct 17,2011) published by
Medscape.com "Screening for
cervical cancer is equally effective with conventional Pap testing and
liquid-based cytology with human papillomavirus (HPV) testing."
The second review focused on the ages at which to appropriately begin and end
cervical cancer
screening. Lead author Kimberly K. Vesco, MD, MPH, and colleagues presented
a "narrative review" of risk factors and other epidemiologic considerations.
According to Vesco "the evidence suggests that the potential harms of screening
outweigh the benefit of cervical cancer screening for women under 20." Dr. Vesco
said that the data support discontinuing screening for women 65 years and older
without a history of CIN or cervical cancer who have had recent negative
cervical cancer screening.
Cervical cancer is a slow growing cancer caused by certain strains of the human
papillomavirus (HPV), an extremely common sexually transmitted disease among
women and men. HPV also causes genital and anal warts, as well as oral and anal
cancer. The best way to detect cervical cancer is by having regular Papanicolaou
tests, or Pap smears. (Pap is a shortened version of the name of the doctor who
developed the screening test.) A Pap smear is a microscopic examination of cells
taken from the cervix.
American Council of Obstetric & Gynecology revised recommendations are:
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Women from ages 21 to 30 be screened every two years instead of
annually, using either the standard Pap or liquid-based cytology.
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Women age 30 and older who have had three consecutive negative cervical
cytology test results may be screened once every three years with either the
Pap or liquid-based cytology.
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Women with certain risk factors may need more frequent screening,
including those who have HIV, are immuno-suppressed, were exposed to
diethylstilbestrol (DES) in utero, and have been treated for cervical
intraepithelial neoplasia (CIN) 2, CIN 3, or cervical cancer.
A Pap smear test is reasonable after every
three years, according to the
United States Preventive Services Task Force, sided by American
Cancer Society. “If you test every year you find a lot of benign
infections that would go away on their own,” said Philip Castle of the
American Society for Clinical Pathology. “You end up over-screening,
over-managing and over-treating women who are not actually at
risk of getting cervical cancer.”
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What is Involved?
The best time to get a Pap smear is 10 to 20 days after the first day of
your last period. If menstruating on the day of the test please reschedule.
A Pap smear is performed by a specialist in a few minutes. Lie down on your
back on an exam table with your knees bent, heels resting in supports
called stirrups. Your doctor will gently insert an instrument called a
speculum into your vagina. The speculum holds the walls of the vagina apart
so that your doctor can easily see your cervix. Inserting the speculum may
cause a sensation of pressure in your pelvic area. Then your doctor takes
samples of your cervical cells using a soft brush or a flat scraping device
called a spatula. This usually doesn't hurt.
The sample of cells is evenly applied to a glass slide and sprayed with a
fixative. This sample is sent to the lab for close and careful examination
under a microscope. If the doctor is using a new kind of Pap smear called a
ThinPrep test, the sample is rinsed into a vial and sent to a lab for slide
preparation and examination.
After the Pap smear is performed, the cervix is washed with a diluted
vinegar solution and examined for abnormalities using a light and a
magnifying device (a colposcope). If abnormal areas are detected, further
evaluation is necessary, regardless of the results of the Pap smear.
What the Results Mean?
 If only normal cervical cells were discovered during your Pap smear, you're said
to have a negative result. You won't need any further treatment or testing until
you're due for your next Pap smear and pelvic exam.
If abnormal or unusual cells were discovered during your Pap smear, you're said
to have a positive result. A positive result doesn't mean you have cervical
cancer. It means, further testing is needed to determine the source of the
abnormal cells and their significance. You might have to undergo a procedure
called colposcopy using a special magnifying instrument (colposcope) to examine
the tissues of the cervix, vagina and vulva. The specialist 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
Dated 22 October 2011
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