Pap smear : ABCs of cervical cancer screening

Cervical cancer is one of the most preventable cancers if caught early.

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It is advisable for all women between the age of 25 -65 years to have regular cervical cancer screening before you start experiencing initial symptoms when the abnormal cells are still treatable.

Cervical cancer is one of the most preventable cancers if caught early. A simple test called the pap smear can save your life from cervical cancer. A Pap smear test can detect abnormal cells of the cervix before they become cancerous. These abnormal cells are usually very treatable without affecting your ability to have children.

Essentially, a pap smear test should be done every three years for all women aged between 25 - 65. HIV-positive women should have a pap smear test after every six months or one year from age 18 or at the time of diagnosis then annually thereafter.

How a pap smear is done

You will be asked to remove your undergarment and lie on your back. You will then be given a sheet to cover the lower half of your body. The nurse or doctor will place a speculum in the vagina to enable them to visualise the cervix. This should not hurt if you allow your body to relax.

A small brush is then used to obtain some scrapings from the cervix (much like rubbing the inside of your cheek with a toothbrush). The cells are put on a slide and taken to the lab where a pathologist looks at them.

A normal pap smear means your cervix is normal and healthy. A pap smear may also show signs of infection or inflammation. However, it does not check for sexually transmitted infections, there are other tests for that. Abnormal cells are a sign of precancerous changes which require treatment.

In case abnormal cells are detected, you may be advised on either additional tests such as an HPV test to detect the human papillomavirus or a colposcopy. This test will give more information about the degree of changes in the cells. If the colposcopy shows abnormal cells or precancerous cells (dysplasia), these will have to be treated.

Your treatment options

There are several ways of treating the abnormal cells. The procedure for treating the abnormal cells can be done as an outpatient procedure or a day surgery case and you may go home the same day. You will be able to have children even after these procedures.

In case you had a hysterectomy (surgery to remove the uterus), you need to check with your doctor first to advise if cervical screening is necessary.

What about human papillomavirus vaccine?

It is advisable to get the HPV vaccine from your healthcare provider, especially if you fall within the recommended age bracket. The vaccine is designed to prevent infection in women who have not been exposed to this virus. They are best suited for girls and women between the ages of 9 - 26 years.

The vaccine does not prevent all cervical cancers, and therefore you will still need regular pap smears even though you have been vaccinated.

Dr Jonathan Wawire, Consultant Anatomic and Histopathologist at Aga Khan University Hospital, Nairobi.

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