Screening for a disease by its detection in an early and curable stage is one of the most important goals of modern medical care. The Papanicolaou test known also as Pap smear or cervical smear has proved over the years that is one of the most valuable screening tests for detection of precancerous changes of the uterine cervix.
What is the Papanicolaou test?
The Papanicolaou test was invented by George Papanicolaou in 1928. It is based on the collection of a small amount of cells from the surface of the uterine cervix that are checked under the microscope. The aim is to assess if there are early changes in the cervical cells (precancerous changes) that are usually caused by HPV infection. The precancerous changes if left untreated could potentially cause cervical cancer.
Most women are going to have a normal Papanicolaou test. However in 1 out of 20 women the test is going to show an abnormality.
Why should I have a Papanicolaou test?
Cervical cancer can be prevented because precancerous changes can be detected and treated early.
Who should have a Papanicolaou test?
It is recommended that all sexually-active women have a Papanicolaou test starting around 21 years of age until the age of 65.
Cervical cancer is more common in women who:
- Smoke
- Have multiple sexual partners
- Have impaired immune system
How reliable is the Papanicolaou test?
There is no test that is 100% reliable and the Papanicolaou test is not an exception. The test, when combined with a regular program of screening and appropriate follow-up, can reduce cervical cancer deaths by up to 80%. Not having regular screening and lack of appropriate follow-up of abnormal smears are two of the most important factors of failure of prevention of cervical cancer by the Papanicolaou test.
In some cases the test needs to be repeated because:
- There is infection that needs treatment
- There is blood or mucous that do not allow for interpretation of the sample
- The sample taken is not adequate
What happens if the test is abnormal?
If the test is abnormal the results are going to be discussed with the woman and in most cases she is going to be advised to have further tests such as colposcopy or HR-HPV test and appropriate follow-up.