Choose the content to read

• Pap Smear (Pap Test)
• How many types of cervical cancer screening?
• What is the recommended age and frequency for pap smear tests?
• How should you prepare for a pap smear test?
• Pap smear test report
• FAQ
• A note from MedPark's doctor

Pap Smear (Pap Test)

Cervical cancer is one of the most prevalent cancers among Thai women and one of the few cancers that can be screened or treated at the precancerous stage before transforming into cancer. Cervical cancer screening, therefore, plays a crucial role in minimizing the mortality from cervical cancer.

What is cervical cancer screening? and How many types of cervical cancer screening are there?

Cervical cancer screening involves collecting cervical cells for a laboratory test. Screening tests for cervical cancer include:

1. Pap smear is a traditional test for cervical cancer. In this test, a gynecologist collects cervical cells with a wooden spatula, places them on a slide, and sends them to a laboratory for inspection.
2. ThinPrep Pap test is a newer test designed for increased accuracy. A gynecologist collects cervical cells with a cytobrush, preserves them in liquid media, and forwards the specimens to a laboratory for centrifugation to separate cervical cells from the mucus and blood cells, enabling more accurate detection of cervical cell abnormalities.
3. HPV DNA tests are often paired with a ThinPrep Pap test to detect high-risk HPV oncogenic virus for cervical cancer. The test that combines the two tests is called co-testing, a comprehensive test with high sensitivity and specificity.

Cervical cancer screening can also detect vaginal bacterial or fungal infections. However, it is ineffective in screening for sexually transmitted diseases such as gonorrhea and chlamydia, requiring other tests.

What is the recommended age and frequency for the pap smear test?

1. Women aged 21 and above or those who have been sexually active for at least a year should begin to take the tests.
2. Women aged 21-29 should have a cytology test (Pap smear or ThinPrep Pap test) annually. If the first three tests are normal, the interval of future tests can be every two years.
3. Women who are over 30 years old should also undergo HPV DNA test or co-testing. If no abnormalities are present, screening tests every 3 to 5 years are recommended.
4. There is no upper age limit for cervical cancer screening. Women can undergo a screening test as long as they are at risk or sexually active.
5. Women who have received treatment for premalignant lesions (CIN II, CIN III, AIS) or cervical cancer still have a high risk of persistent or recurrence of cervical cancers. Regular screening is advisable according to doctors' recommendations.
6. Women who have their uterus and cervix removed and have no history of premalignant lesions or cervical cancer may be able to omit cervical cancer screening. However, they should have a consultation with a gynecologist for individual assessment.

How should you prepare for a pap smear test?

• Avoid cervical cancer screening during a menstrual cycle.
• Avoid sexual intercourse, vaginal douching, or using vaginal suppositories at least two days before a screening test.

They can interfere with the accuracy of the cytologic examinations.

What are the steps involved in a pap smear test?

• Change into a hospital gown.
• Empty the bladder before the test.
• Lie flat with your legs on stirrups in a relaxed position.
• A gynecologist will insert a vaginal speculum to view the cervix.
• During instrument insertion and cervical cell collection, you will experience slight pelvic pressure.
• A medical assistant or female nurse chaperone will accompany you through the screening test.
• Mild lower abdominal discomfort or light vaginal bleeding may occur within the first 24 hours after the cervical screening test. They will then resolve.
• You will get your lab report within 7-10 days.

Photomicrograph of Pap Smear

Pap smear test report

• A negative test (no abnormal cells found) or mild inflammation at the cervix: No additional treatment is needed. The next screening test is scheduled based on a doctor's advice.
• Vaginal fungal or bacterial infection: It is advisable to see a doctor for further treatment.
• A positive result (abnormal cells detected): It is advisable to consult a doctor for follow-up checkups or additional diagnoses such as a colposcopy.
• An inconclusive result or inadequate cells in the sample can happen in women with menopause or vaginal dryness. A repeat test may be required.
• False negative or false positive results can happen in cervical cancer screening tests. In such cases, repeating the test may be required.

Frequently asked questions

• Is a pelvic exam the same as cervical cancer screening?
  A pelvic exam involves the detection of abnormalities in female reproductive organs, including a visual examination of the vagina and cervix and bimanual palpation of the uterus, ovaries, and other reproductive organs to detect abnormalities, including polyps, tumors, or cysts. The gynecologist may perform cervical cancer screening in the same sitting.
• Is cervical cancer screening necessary after cervical cancer vaccination?
  Women who have received cervical cancer vaccination should also undergo cervical cancer screening tests like other women. The vaccine does not include all oncogenic HPV strains.

A note from MedPark's doctor

Don't let fear of discomfort hold you back. Cervical cancer screening is a quick and crucial test when performed by skilled doctors. Early detection of abnormal or cancerous cells significantly increases the chances of successful treatment. Should you have any questions or concerns, contact MedPark Hospital's Obstetrics and Gynecology Clinic, 7th Floor, Counter D, Tel. 02-090-3135