Pap smear or Pap test is a test method to detect the presence of cervical cancer or cervical cancer in a woman as early as possible, so that it can be treated immediately. In addition, by undergoing regular Pap smears, the condition of cervical tissue can be well known and doctors can predict whether or not cancer will occur in the future.
Pap smears are done by rubbing the cervix to take cervical tissue cell samples. This sample is then observed in the laboratory, so that if there are abnormal cells it can be identified. Pap smears can also detect other abnormalities in the female reproductive organs besides cancer, such as inflammation and infection.
Pap Smear Indications
Pap smears are recommended to be done routinely on women aged 21 years and over every 3 years. Meanwhile, women who are aged over 30 years to 65 years, can do a Pap smear every 5 years, but need to be combined with HPV DNA examination.
If someone has a factor that can increase the risk of cervical cancer, can undergo a Pap smear more often than the general recommendation. Factors that can increase the risk of cervical cancer in a person are:
- Suffered from HIV infection.
- Experiencing immune system disorders, such as due to organ transplantation, chemotherapy, or the use of corticosteroids for a long time.
- Previous Pap smear results showed precancerous lesions, including atypical squamous cells, intraepithelial squamous lesions, or atypical glandular cells.
Women who have had a total hysterectomy, which is a total surgical removal of the uterus and cervix, can stop to undergo a Pap smear. The condition is that the total hysterectomy performed on the woman is not caused by cancer or precancerous lesions. If a total hysterectomy is performed due to a cancerous or precancerous condition, the woman must still undergo regular Pap smears.
Women who are over 65 years old and the results of a previous normal Pap smear can stop undergoing a Pap smear.
Pap Smear Warning
Pap smears should not be done by pregnant women 25 weeks and over until 12 weeks after giving birth, because it will feel painful and the results are less accurate. Pap smears also should not be done during menstruation, because it can make the results less accurate.
Pap smears are a very safe method for women to detect cervical cancer. After undergoing this procedure, mild bleeding can occur through the vagina, whereas heavy bleeding is very rare.
Pap Smear Preparation
Women who will undergo a Pap smear are not allowed to have sexual relations 2 days before this procedure is performed. In addition, it is also not permissible to use spermicides, vaginal medicines, jelly or vaginal creams because they can get rid of abnormal cells that are in the female genital organs.
If you are nervous before undergoing a Pap smear, you should consult with your doctor beforehand, so that you can be helped to relax so as to facilitate the examination.
Procedure for Pap Smear
Pap smears are generally carried out by obstetricians and obstetricians. Patients will be asked to change their clothes to other clothes that are more loose, or to undress the bottom. The patient will then be asked to lie on his back on a special table and spread his thighs and bend his knees, so that the doctor can more easily perform this procedure.
The doctor will then insert a special instrument called a speculum into the patient's vagina. The speculum will hold the vaginal wall wide enough, so that the doctor can more easily see cervical tissue. The patient will feel a bit uncomfortable because of the pressure caused by the speculum in her vagina. Then, the doctor will scrape cervical tissue using a spatula, brush, or a combination of both. After completion, the doctor will store the sample in a special container and bring it to the laboratory.
If the results of laboratory tests are not found abnormal cells, it can be concluded that the patient does not have cervical cancer. Patients who get negative results on a Pap smear are not required to undergo further diagnosis. Pap smear results are said to have positive abnormal cells, both cancerous and precancerous lesions, if found one of the following types of abnormal cervical cells:
- Atypical squamous cells (ASCUS). This term means that from the Pap smear examination there are cells that are not normal, but that does not mean that the patient has cells
- Interepithelial squamous lesions. This term means that there are abnormal epithelial cells and are precancerous cells. These cells have the possibility of turning into cancer cells, both fast and slow.
- Atypical glandular cells. This term means that the Pap smear examination found abnormal cells that produce mucus (mucus). However, it is not certain that these cells are cancer cells.
- Squamous cell cancer and adenocarcinoma. This term means that the results of the Pap smear examination found abnormal cells which are likely to be cancer cells.
After Pap Smear
After the Pap smear is completed, the patient can resume his normal daily activities. Clinic or hospital staff who carry out this procedure will contact the patient again to inform when the results are ready. If the Pap smear results show abnormal cells, then the patient is recommended to undergo further tests. This further examination can be a biopsy, which is taking a sample of cells suspected of being cancer cells, or colposcopy to examine the condition of the vaginal tissue, vulva, and cervix visually.
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