BENGALURU: A simple test called the pap smear has become the gold standard for early detection of cervical cancer in women. The test by itself takes just a few minutes in an out-patient set-up where the specialist collects a few cells for testing from the cervix (lower part of uterus). Pap smear sampling of cervix involves scraping of cervical surface and a portion of non-visualised cervical canal using various sampling devices.
In the classic pap smear, five different stains in three different solutions are used. The different stains bring out the different types of squamous cells which line the cervix, right from the superficial, intermediate and deep layers. Pap smears detect not just pre-cancer or cancerous cells, but even inflammation and other changes happening on the cell lining the cervix.
How frequently is a pap smear advised?
We start testing from the age of 21, once in three years. After the age of 30, if combined with an HPV DNA test (Pap-HPV contesting), the frequency can be reduced to once in five years. Advantages of reduced testing includes reduced incidence of Stenosis, Cervical Incompetence, etc. Generally, testing is stopped at the age of 65. However, in certain conditions like immunodeficiency syndromes, HIV, and other high-risk groups, the doctor may choose to test more frequently. HPV is Human Papilloma Virus which infects the cell lining of the reproductive organs and can cause cancer in organs like vagina, cervix, vulva and even penile and anus.
An abnormal pap smear may be followed up by a colposcopy which is a magnifying instrument to better examine the details of the cervix, vagina and the vulva. During the same procedure, tissue biopsy may be taken from areas looking abnormal. The lab analysis aids in definitive diagnosis.
(The writer is director, medical oncology & hemato-oncology, Fortis la femme Hospital)
to get a pap smear done
If a pap test is scheduled within two days, then
Do not douche
Do not use a tampon
Do not use birth control foam/medicines/cream/jelly/lubricants
Avoid during vaginal infections
Postpartum smear should be taken only after
6-8 weeks of delivery
Every seven minutes, one Indian woman dies of cervical cancer, with India having the highest estimated number of cervical cancer deaths. It is no less than an epidemic.