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Pap Smear Test Cancer is one of the most feared diseases falling under the genre of lifestyle diseases. The prevalence of cancer in women has increased rapidly over the past few decades. After breast cancer, cervical cancer is the next most common cancer, and is a leading cause of cancer-related deaths among women. Cervical cancer is cancer of the cervix, which is the lower part of the uterus (womb) that opens into the vagina (birth canal). Cervical cancer can occur in woman of any age above 18 years. In Mauritius, cervical cancer accounts for 65% of gynaecological cancers and 3.4% of the cervical cancers are diagnosed at the stage of carcinoma in situ*. Cervical cancer needs to be checked regularly before it becomes invasive. *Rughooputh S et al. (2006) Detection for human papilloma virus from archival tissues in cervical cancer patients in Mauritius. Journal of Clinical Virology. Volume 35, Issue 2. Pages 173 - 178. 3 The Pap test - A regular check on cervical cancer Pap test (also called Pap smear) is done to detect cancer or changes that may lead to cancer. It is a procedure in which cells are scraped from the cervix and examined under a microscope. A Pap test can also show non-cancerous conditions such as infection or inflammation. Regular Pap tests are part of women’s routine health checkups. There is no age limit for taking a Pap test. Sexually active women over 18 years of age or those going through menopause need to get Pap tests at regular intervals. Many health care providers recommend a Pap test every year, but after having 3 normal Pap tests for 3 years in a row, the period can be extended from 1 to 3 years. 4 A Pap test takes only minutes! A Pap test is a minor test that takes just a few minutes. You will be asked to lie down on an exam table, bend your knees, letting your knees fall to the side. A sheet will cover your legs and stomach. The doctor will put an instrument called a speculum into your vagina, opening it to see the cervix and do the Pap test. Your doctor will then use a special stick, brush or swab to take a few cells from inside and around the cervix. The cells are placed on a small glass slide, and then checked by a lab to check whether they are healthy. This simple test is also painless for most women. However, in some abnormal cases, it may cause a little discomfort. It is always important to get a Pap test done under the proper guidance of your health care provider. Prevention: well-in-advance A timely Pap test can surely be a lifesaver, detecting precancerous cervical lesions at an early and treatable stage, well before the cervical cancer becomes invasive. Even if there is a minor change on the cervix, it needs to be evaluated, diagnosed and treated. Of course, when changes are diagnosed as pre-malignant, they need to be tested as soon as they are seen. Investigating beyond the Pap test After screening of the sample, the Pap test can tell you if you have an infection, abnormal (unhealthy) cells, or cancer. If the cells are found normal, no treatment is required. If an infection is present or the cells look abnormal (or unhealthy), more tests may be prescribed along with the treatment. Because a Pap test is not 100% right all the time, the results should always be discussed with your doctor. If the Pap test shows something confusing or a minor change in the cells, the test may be done again. If results show a major change in the cells of the cervix, your doctor may also take a small amount of tissue from the cervix (called a biopsy) to examine for any abnormal cells, which may show evidence of cancer. 5 Cervical cancer: risk factors Any woman can get cervical cancer. But the chances of getting cancer of the cervix increase under certain conditions: • When sexual activity has begun before the age of 18. • When there have been many sexual partners. • When sexual partners in turn have other sexual partners. • If one has had Human Papilloma Virus (HPV) or genital warts. • If one has or has had a Sexually Transmitted Disease (STD). • If one is over 60 years of age. • If one smokes. 6 After undergoing a Pap test, make sure that you discuss your results with your doctor. Approximately 1 in 10 tests shows some abnormality. But abnormal Pap test results usually do not mean you have cancer. Most often, there is a small problem with the cervix. All you need to do is ensure follow up action with your doctor between every Pap test. Your doctor will advise you if any treatment is required. 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