Having a Pap smear every two years offers the best chance of preventing cervical cancer. In 2005, 734 cases of cervical cancer were diagnosed in Australia.
The Pap smear is a quick and simple test used to check for changes to the cells of the cervix that may lead to cervical cancer. A doctor or nurse takes a sample of cells from the surface of the cervix and smears them on to a glass slide. The slide is sent to a laboratory for analysis and the results are usually available within a week.
Most Pap smear results are normal. A small number show changes in the cells of the cervix, mostly minor infections that usually clear up naturally or are easily treated. In a very small number of cases the abnormality persists and if left untreated, may develop into cervical cancer. When detected early, changes to the cells of the cervix are easily managed.
Why have a Pap smear?
The Pap smear is currently the best test available for the prevention of most cases of cervical cancer. It is important to know that no screening test is 100 per cent accurate. However, all women between the ages of 18 and 70 should have a Pap smear every two years. Women should start having Pap smears between 18 and 20 years of age or one to two years after becoming sexually active.
What about the vaccine for cervical cancer?
Cervical cancer mostly occurs as a consequence of a human papillomavirus (HPV) infection. HPV is a common viral infection, affecting at least 75 per cent of sexually active adults at some time in their life.
Women who are not yet sexually active and not infected with HPV will benefit most from the vaccination. There is also benefit in vaccinating sexually active women, as they may have not yet been infected with one of the types of HPV that can cause cervical cancer.
The currently available vaccines are targeted only at the HPVs responsible for two thirds of cervical cancers, therefore all vaccinated and unvaccinated women will still need regular Pap smears.
What is an unsatisfactory Pap smear?
An unsatisfactory Pap smear means that the laboratory staff could not see the cells well enough to give a report. In this case, you may be asked to have a repeat Pap smear. This is not a cause for alarm.
What does an abnormal Pap smear result mean?
An abnormal Pap smear result means that when the cells from your cervix were examined, some of them looked different from normal cells. This occurs in around 1 in 10 Pap smears.
It is natural to feel anxious or worried if you have just found out that your Pap smear result is abnormal, however it is important to know that less than one per cent of abnormalities are cancer.
Low grade abnormalities result from slight changes in the cells of the cervix, which may be the result of a mild infection such as thrush or HPV.
HPV is present in 99.7 per cent of cervical cancer cases. However, not all HPV infections lead to cervical cancer. There are more than 200 different types of HPV, but only a few that affect the cervix. Most women don’t know they have HPV until they receive an abnormal Pap smear result. For most women the body usually takes between one and two years to clear the virus naturally. However, in some cases HPV may take longer to clear from the body, increasing the risk of developing cervical cancer.
If you have a low grade abnormality and your previous Pap smears were normal, your doctor will ask you to come back for a repeat Pap smear in one year. This allows time for the body to naturally clear the HPV infection. If the repeat Pap smear returns an abnormal result you will be referred to a specialist for further investigation. This is called a colposcopy. This involves your doctor using an instrument called a colposcope, which provides a magnified view of the cervix to check the extent and nature of any abnormalities.
High grade abnormalities can result from more severe changes to the surface layers of the cervix. If left untreated they have a greater chance of developing into cervical cancer.
It usually takes at least 10 years before high grade abnormalities develop into cervical cancer. If you have a high grade abnormality your doctor will refer you to a specialist for further investigations.
How will I know when to have my next Pap smear?
Most doctors have an established recall system to notify you of when your next Pap smear is due. Most state health departments have established Pap smear registries that provide a safety net recall system. You can opt out of your state Pap smear registry. The registry acts as a back up for women who don’t follow-up on their reminder.
Remember, if you have any concerns or questions, please contact your doctor.
Where can I get reliable information?
Cancer Council Helpline 13 11 20
Information and support for you and your family for the cost of a local call anywhere in Australia.
Cancer Council Australia website
(with links to state and territory Cancer Councils)
www.cancer.org.au
National Cervical Screening Program 13 15 56
www.cervicalscreen.health.gov.au