Health awareness: Pap Smear

What is a pap smear?
A pap test or pap smear is named after George Papanicolaou. The test was introduced in 1948, it checks the cervical cells (on the opening of the womb) for changes that may later become cancer (pre-cancerous cells). The test can also detect sexually transmitted infections such as HPV (human papilloma virus).

Why is a Pap smear important?
Early detection of pre-cancerous cells allows healthcare providers an opportunity to treat and eliminate cervical cancer. Pap smears yield different results which can either be normal, inconclusive or abnormal. Normal findings are interpreted taking into account one’s age and risk factors. If one is sexually active, the presence or absence of the HPV infection (viral infection linked to the development of warts or cervical cancer) guides the frequency of future tests. Abnormal findings may be mildly abnormal or highly suggestive of cervical cancer changes.
If highly suggestive changes are detected on the cervix, further investigations and interventions are done for diagnosis and treatment. If cervical cancer is detected, early treatment options will be offered to the patient to minimise local and distant spreading of cancer cells. This way, complications and deaths from cervical cancer will be reduced.

Who should test and how often?
Reliable sources recommend an annual Pap smear test for all women who are sexually active. If one has three consecutive normal tests done yearly, one can then continue with pap smears every three– five-yearly intervals.
Non-sexually active women are advised to consider pap smear tests starting at age 25. Other risk factors for cervical cancer besides HPV infection are; early age of intercourse and multiple sex partners, a family history of cervical cancer, specific hormonal therapy (including long term oral contraceptive usage), being overweight, a weakened immune system (HIV for instance) and smoking.
Other sources recommend yearly pap smears from the age of 21 to 30. During this time interval, pap smears can be done every three years if normal. That’s about three tests in total.
Abnormal tests are however repeated based on the cell types isolated in the laboratory.
In the public health sector, women are allowed three free pap smears from age 30 to 50, at 10-year intervals. Because of financial reasons, such screening intervals exist for all South African women. Using this screening system, cervical cancer cases are reduced by 67%. In an ideal world, where women are screened annually, cervical cancer cases would be decreased by 93%.

When to go for a Pap test
If you do not fit in any of the above-described groups or are of very minimal risk factors, speak to a health professional. The same applies if you have had any previous pap smears which were considered inconclusive or abnormal.
If you were wondering when would be a good time to go for a test during your menstrual cycle, some experts advise two weeks after the first day of your period. Other experts advise that one avoids intercourse, douching or inserting any vaginal creams two days before the test.

Where to go for a Pap smear
Speak to health professionals in your area for centres that will suit your pocket. Women’s wellness centres, clinics, community health centres, general practitioners, public or private hospitals offer pap tests at different prices.