Community knowledge regarding HPV (Human Papilloma Virus) and the HPV vaccine (Gardasil) has certainly improved understanding regarding cervical cancer and effective prevention. However, as a GP, I have noticed that many women assume a course of Gardasil means no more pap smears.
Furthermore, many younger women tell me that they have no education regarding sexual and reproductive health. This highlights the importance of a regular GP invested in your future health! A regular pap smear is a good opportunity to discuss sexual health and contraceptive choices.
The question we know you don’t like to hear – “when was your last pap smear?” and why we always ask …
What is a pap smear?
A pap smear is a procedure that takes a sample of cells from the cervix, where the uterus (womb) opens into the vaginal canal. The sample is analysed to identify any precancerous or cancerous cells. For some time we have known that the many types of HPV can cause cancer of the cervix.
Why is it called a pap smear?
It is named after Dr Georgis Papanicolou, who discovered the cancerous cervical cell changes in the 1920s and implemented the ‘papanicolou – pap’ smear from his findings. His pioneering work has led to improved detection and treatment. Historically, cervical cancer was a leading cause of death amongst women.
The HPV vaccine has since been discovered and prevents a myriad of cancers including cervical, anal, vaginal and genital, not to mention the dreaded genital warts! However, despite the immunisation, pap smears are still an important screening tool and should be performed every 2 years for women from 18-70 years of age who have ever been sexually active.
For some women who have had precancerous cells or cancer that has been treated, they will require more frequent testing and are guided by their GP or gynaecologist.
Cervical cancer is slow growing. If picked up early, it is easily treated.
It is important to know that a pap test is a screening tool, which means that if your pap smear is negative and you have symptoms of concern, you should discuss this with your GP. You may require further investigation.
In May 2017, the national guidelines will change for those women who have completed a course of Gardasil where screening will extend to a 5 yearly program. Until then, it is business as usual and it is advisable not to delay screening!
What if you're nervous about pap smears?
Firstly, it helps to be informed and familiar. Hopefully now you can see why we place so much importance on regular smears as well as HPV immunisation. Being familiar with the process and the equipment can help you feel at ease. Ask your GP to show you what instruments are used. Lastly, it can take time. GPs understand the importance of not rushing things. Book a long appointment so that we can ensure it is a smooth process and you will not resent the reminder to come back next time! We all have our own ways in helping you feel relaxed.
Of utmost importance is a fear associated with pap smears after sexual violence. There are many ways of helping women with overcoming this fear and this may require psychological support. 1 in 3 women are a victim of sexual harassment or violence, it is an unfortunate experience that can make pap smears a difficult task. With the right support and guidance, it can be achieved and most women feel empowered after achieving this goal for themselves.
Image Credit: MedBroadCast.com