Reasons to Have a Cervical Smear (Pap) Test

Women and girls who have had to undergo a cervical smear test will readily admit that they did not look forward to the procedure. It is not the most dignified of tests that women will have to submit to, but it is important to overcome feelings of embarrassment and still go through with it. The purpose of the test is to detect pre-cancerous changes in the cervix (neck of the womb). Pre-cancerous changes, also called cervical intra-epithelial neoplasia, or CIN for short, are common in all age group and cause no symptoms. This means women may not be aware of CIN unless they have a smear test.

If left untreated, pre-cancerous changes might develop into cancer of the cervix. Pre-cancerous changes can also go away by themselves. However, even your doctor cannot determine which woman's pre-cancerous changes will go away if left untreated and which woman's pre-cancerous changes will develop into cancer. Doctors cannot say for sure how long it takes for abnormal cells in the cervix to develop into cancer. But if preventive measures are not taken to treat the abnormal cells, cancer can develop in about 50% of cases, even though this might take several years until it occurs.

The smear test is often carried out in conjunction with a pelvic examination. A small flat spatula is inserted into the vagina and a sample of surface cells is taken from the cervix. The specimen is then placed on a small glass slide, fixed, stained and sent to a laboratory to be carefully examined. The laboratory technician will examine the specimen and then decide whether the smear test is normal, borderline normal, mild, moderate or severely abnormal.

If the test result comes back as normal, the patient will not need another smear test for three years. But if the patient is informed that the test result is borderline or mildly abnormal, she will be asked to have another smear test within 6 or 12 months time. A moderate or severe abnormality means the woman will be informed and invited to attend a colposcopy clinic for further tests and treatment.

A colposcopy is a procedure that the gynaecologist performs, by examining the surface of the cervix using a magnifying instrument called a colposcope. Cell changes cannot be seen directly by using this instrument, but the fine blood vessels under the cervix develop noticeably during cell changes. This is what the gynaecologist will look out for. In cases where cells have changed, they will be able to estimate how far they have grown and how much they have changed. Biopsies will be carried out from the site on the cervix where the colposcopy has detected the cell changes.

If cell changes have occurred in the woman's cervix, the patient will usually be advised to have this tissue removed. There are many ways of doing this, including a diathermy loop or by using a laser. Most of the procedures available now can be easily performed with a local anaesthetic, while the patient is still awake. These procedures can cause some bleeding, but the cervix should heal quickly. The pre-cancerous tissue that has been removed will be replaced by new, healthy tissue.

The patient will be advised on how to have follow-up smear tests after this procedure. This depends mostly on the severity of the pre-cancerous cells that were removed. Even though this treatment is very effective, pre-cancerous changes can return. That is why it is important to continue with the follow-up appointments.
Women should not wait until there is an abnormality to have a cervical smear test performed. In the UK, screening is in place for women over the age of 20 to have a test every three years. Teenagers who are sexually active can also have a cervical smear test, if they request one. According to Dr Erik Fangel Poulsen, a specialist, three-yearly examinations are sufficient. He believes that more frequent examinations do not produce better results in preventing cervical cancer. Women in America should decide for themselves if three-yearly or annual exams are required for their overall health and wellbeing. It is important to not ignore the cervical smear altogether. It is unpleasant, but it can help save lives.

Source:

http://msn.netdoctor.co.uk/uk/msn/articles/health_advice/examinations/paptest.shtml