Why have a Pap smear?

The Pap smear is currently the best test available for the prevention of most cases of cervical cancer. 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. It is important to know that no screening test is 100 per cent accurate.

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.

There are more than 200 different types of HPV, but only a few that affect the cervix. Vaccines are now available that prevent the types of HPV infection that cause most cervical cancers. Currently the available vaccines do not protect against all the types of HPV that can cause cervical cancers. All vaccinated and unvaccinated women 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 some cells from your cervix 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 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.

Most women don’t know they have HPV until they receive an abnormal Pap smear result. For most women the virus clears naturally in one to two years. 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 result is abnormal you will be referred to a specialist for further investigation, called a colposcopy. The specialist uses a colposcope toget 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 leftuntreated 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 and treatment.

How will I know when to have my next Pap smear?

Most doctors have an established recall system to notify you when your next Pap smear is due. Most state health departments have established Pap smear registries that provide a safety net recall system although you can opt out. Remember, if you have any concerns or questions, please contact your doctor.