PAP Smear

A PAP Smear is conducted to check for abnormal cell changes in the cervix that can potentially lead to cervical cancer. It is important as it aids in the prevention of cervical cancer. The test is performed by collecting samples of the cervix that are then examined microscopically to detect abnormal cell changes. 

A Pap Smear relies on cytology which includes the study of the structure and functions of living cells. A cytoproct is inserted into the cervix to obtain for cervical cells which are later inspected for any changes associated with cancer. Depending on the findings, the cells are labelled normal, abnormal, or equivocal, and subsequent diagnosis or therapy is planned accordingly. 

This procedure, PAP smear, seeks for abnormal cells in the cervix, which encompasses:  

1. Precancerous cells such as abnormal squamous cells or high-grade squamous intraepithelial lesions (HSIL) 

2. Cancerous cells such as adenocarcinoma or carcinoma of the squamous cell 

3. Changes in cells that are suggestive of cervical cancer like HPV (human papillomavirus) infections. 

The most common scenarios when a PAP smear is carried out may include: 

• During a pelvic examination, as part of the woman’s annual health assessment 
• After an abnormal PAP result to look for changes in cells and determine if any treatment is necessary. 
• After colposcopy or biopsy for abnormal cells checks. 
• For women aged 21 to 65 years as a general screening test. 

Even though Pap smear is regarded as one of the most reliable tests available in medicine today, it still poses a few potential risks and limitations: 

1. Missed abnormal cells, false negatives.  

2. Positive findings of normal cells as abnormal cells.  

3. Cell changes are present but unclear, inconclusive. 

4. Painful sensation while taking the test 

5. Any signs of bleeding or infection after it 

It is very important to clear any of your questions or fears with your doctor to get all the right information. 

The following parameters are evaluated in the PAP Smear: 

1. Morphology of Cells: Shape, size, and colour of cells. 

2. Cell Arrangement: Pattern of cell distribution on the slide. 

3. Atypical Cells: Presence of cancerous and pre-cancerous cells. 

4. HPV Detection: This test can reveal the presence of HPV which can lead to cervical cancer. 

Doctors may alter the test based on the patient’s; 

1. Age: Women younger than 21 may not require PAP Smear while women older than 65, may require it once in a few years 

2. Past Results: Women with abnormal PAP Smear tests may need to be examined more frequently. 

3. Clinical History: Women with prior HPV infection or cervical cancer may need an examination more frequently. 

1. Women aged 21 to 65 years should get routine PAP Smear test done, so should women with; 

2. History of cervical cancer or HPV infection. 

3. Previous abnormal PAP Smear test results. 

4. Risk factors like HPV or other factors contributing to the risk of cervical cancer. 

1. When looking for the best treatment options for cancer of the cervix, a Pap smear is very effective for detection of early stages of cervical cancer.  

2. A Pap smear is also preventive; in that it looks for precancerous cells that could potentially develop into cervical cancer.  

3. A pap smear is effective in monitoring if any treatment is required or not.  

4. A cervical screening using a Pap smear reduces risk of cervical cancer by the HPV using recombination strategies. 

These are some of the conditions a Pap smear may assist in diagnosing: 

• Cancerous cervix 
• HSIL - high-grade cervical intraepithelial neoplasia 
• HPV  
• Atypical squamous cells of uncertain significance (ASCUS) indicative of cervical cancer 

1. Abstaining from marital relations and any forms of vaginal applications for more than 24 hours is encouraged.  

2. Wear loose garments, preferably a dress or pants, that can be easily taken off for easier access during the test.  

3. Letting your doctor know of any medical conditions should be made mandatory.  

Prerequisites:  

1. Patients should not be under the age of twenty-one during a Pap smear test.  

2. The adult patient should not be on their menstrual cycle at that moment of the test 

3. You should not have had a cervical PAP Smear test that was earlier positive for cervical cancer or tested positive for high-risk HPV. 

Eligibility: 

1. Eligible candidates for the PAP Smear are women aged 21 – 65 years. 

2. Women who have had cervical cancer previously or had HPV infection are likely to qualify for testing more often 

Procedure to Take the Test: 

1. Undress and lie down on an examination table. 

2. Place your feet in stirrups for the healthcare provider to perform a pelvic examination. 

3. A healthcare provider will place the speculum to keep the cervix still, while a nurse inserts the device. 

4. A spatula, or brush-like device, is passed through the opening to collect a sample from the cervix. 

5. During the procedure, you may feel pain with cramps. 

Cautions Before Taking the Test: 

1. It’s best to abstain from douching or deodorant use prior to the examination.  

2. Women who are pregnant or have suspicions regarding their condition should inform their doctor before the test.