We owe many lives to the sacrifice of Mrs Papanicolaou for what is now a commonplace screening test. Dr Georgios Papanikolaou (and Dr Aurel Babeș not long before him) had discovered that by examining the cells of the cervix, they could see if any cancerous or precancerous cells were visible.
We’ve come a very long way since 1923, and soon the pap smear will be replaced with a more sensitive and more specific test known as the HPV test.
However until the new screening program is in place the recommendation is still to have 2 yearly pap tests (as we never know if the new program will be delayed – it already has been once).
With the regular pap smear, cells are taken from the surface and the entrance of the cervix and are looked at under a microscope. This is either done on a slide, or in a liquid known as liquid based cytology.
If there are any abnormal cells, the abnormality is graded into low and high grade changes, and your doctor will chat to you about what happens next. These changes are not diagnostic of cancer, but mean we’ll need to do repeat pap smears sooner, or arrange for further testing to clarify what’s going on.
When the new screening test comes in we’ll be testing for the HPV virus itself which is the precursor to most changes.
All women who have ever had sex (this includes male to female, and female to female sex) or skin to skin genital contact, are recommended to have a pap smear.
Pap smears should start between the ages of 18-20, or two years after first having sex, whichever is later
In order to collect a good sample and reduce the chance of requiring a repeat test, it’s best to wait until your period has finished to organise your pap smear.
With the new program screening will commence at the age of 25.
An abnormal result does not necessarily mean you have cervical cancer. Most changes in the cervical cells are due to HPV infections, which clear up on their own without any need for treatment.
In a small number of women these changes can progress to high-grade abnormality. And in an even smaller number of women persisting high-grade changes may progress to cervical cancer.
However 80% of cervical cancers are detected in women who have never had a pap smear, or haven’t been having regular screening.
An abnormal result means another test is often required, which may be a repeat pap smear at a shorter interval, or some further tests via a gynaecologist.
The HPV vaccine has been an amazing discovery that Australia can very proudly call a homegrown success story. And while the HPV can reduce the risk of contacting some high risk types of HPV, it doesn’t protect against all causes of cervical cancer, hence why regular screening is still an important step in prevention.
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