What is Pap smear?
Pap smear is an important screening tool used by doctors to detect cervical cancer or abnormal cells in the cervix. This is done by sampling cells from the cervix which is the small and narrow portion that connects the uterus to the vagina.
Cervical cancer is the type of cancer that develops at the cervix.
The cervix has two parts, each part having different types of cells Ectocervix: is the outer portion of the cervix and it also protrudes into the vagina. Endocervix: is the innermost part of the cervix. Most cervical cancers and precancerous cells from where these two cell types meet called squamocolumnar junction (SCJ) The SCJ contains column-like mucus-secreting cells from the endocervix and squamous cells that resemble fish scales from the ectocervix.
What happens during Pap smear procedures?
During Pap smear procedures, samples of cervical cells are taken using a brush or spatula, these samples are sent to the lab for testing for abnormal cells. Human papilloma virus (HPV) test may also be carried out using cell samples obtained during Pap smear. HPV is a sexually transmitted viral infection associated with genital warts and cervical cancer.
Why is Pap smear so important?
It helps to make early diagnosis of cervical cancer especially at the point in which cure or effective treatment is still possible. Cervical cancer used to be one of the most common causes of cancer deaths among women in the western world, but this has been reduced to the barest minimum. Thanks to regular Pap smear and its early detection of pre-cancer stages. In Nigeria however, cervical cancer still remains the 2nd most frequent cancer and one of the most common causes of cancer deaths among our women.
Who needs Pap smear?
Every sexually active woman from age 21 to 65. However, HPV vaccines are recommended to be given as early as age 11 and 12. These offer protection against certain types of HPV.
How often should Pap smear be done? According to the United States Preventive Services Task Force (USPSTF), it is recommended that Women aged 21–29 years should have a Pap test every 3 years.
Women aged 30–65 years should have a Pap test every 3 years, or an HPV test every 5 years, or a Pap and HPV co-test every 5 years. After the age of 65 years, most women will not need a Pap smear. Individual risk factors vary so doctor may advise more frequent testing especially if a person has certain risk factors.
What is the next step after an abnormal Pap smear test?
A positive Pap smear test is not the same thing as cervical cancer. It means that some abnormal cells are found in the cervix or vagina. The next step is COLPOSCOPY which is a minor procedure that is done using a microscope to visualize the cervix especially around the SCJ. During this procedure, samples are taken from any abnormal area for biopsy and confirmation of cancer.
What if Pap smear tests lead to a diagnosis of cervical cancer?
The next thing is to seek treatment immediately. The oncology team will request for necessary investigations so as to stage the disease and plan treatment accordingly. Regular screening; the key to early detection of cancer and achieving a more favorable outcome.
The importance of Pap smear for regular cervical cancer screening cannot be overemphasized. Early cancer detection is the key to achieving a cure or obtaining a good prognosis.
Dr Andero ET
Radiation Oncology Unit Eko Hospital Corps.
