Pap Smeer

The PAP test owes its name to one Papanicalou, who developed the staining technique to expose the nucleiof cells under going maligant change. The test is designed to identify women at risk of developing cancer of the entrance to the womb (the so called cervix).

The cervix is accessed with the aid of a spectrum and cells from the cancer prone area are collected by means of a small brush or wooden spatula. At the laboratory the smear is stained using the Papaniclou technique and examined by a cytologist.

The common form of cervix cancer has a fairly predictable and rather slow progression. The early stages generally resolve spontaneously, although between 5% and 15% may progress to eventuallybecome cancer.

Who is at risk of Cervix cancer?

Essentially all women who are sexually active are at risk. Sexual activity at a young age (i.e. in adolescence) is a particular risk factor due to the relative immaturity of the cervical cells at this stage. These cells are particularly susceptibles to carcinogens, especially virus cells which may be transmitted in seminal fluid. The viruses associated with cervix cancer are certain types of the Papiloma Virus (the wart virus) and the Herpes Virus.

How often should a PAP smear be performed?

your first PAP should be performed about a year after commencing sexual intercourse. Provided the resluts are negative, it should be repeated each year for a further two years. This is necessary as the test is unfortunately not very sensitive and will only identify about 40% of abnormal cells the first time round. In a monogamous relationship, PAP tests can thereafter be performed at 3 yearly intervals, unless advised different by your doctor.

Not being in a monogamous relationship does increase your risk and annual smears should be performed. If viral cells or pre-maligant cells are noted, the smear will need to be repeated in 3 - 6 months and you may be advised to go for a coloscopic examination (essentially examination of the cervix through a microscope).

Not all pre-maligant lesions need to be treated and in those that do, treatment is generally fairly simple and does not affect fertility. A regular PAP test will essentially exclude the possibilty of advanced cervix cancer and still remains an important inconvenience for the health conscious woman.

Patient information leaflets - Royal College

Dr Douglas Seton, Obestetrician & Gynaecologist Knysna © 2021

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