A pap smear is a quick and simple method of cervical screening to detect changes in the cervix that may lead to cervical cancer in women.
Using the pap smear as a screening test to help detect any abnormal changes earlier can have huge positive benefits, as treatment can be undertaken in early stages of the condition, which is more likely to be effective.
Cervical cancer is the fourth most common cancer for the worldwide population of women. In 2012 there were an estimated 266,000 deaths from cervical cancer. The vast majority of these cervical cancer deaths (90%) occur in less developed regions, which is most likely due to the lack of screening programs.
Since screening began in developed countries, the number of women diagnosed with cervical cancer has dropped by an average of 4.5% each year. This is most likely because women are able to detect subtle changes earlier, preventing the progression to cancer with preventative treatment.
Women who have had a hysterectomy
Even women who have had a hysterectomy may need to continue to have a pap smear. Some example of women who should continue to a pap smear are those who:
- Did not have their cervix removed
- Did not previously have regular tests
- Have had abnormal test results in the past
- Have had gynaecological cancer
If the cervix was removed and the woman had had regular pap smears with no abnormalities, then there is no need to continue to get pap smears.
Women with disabilities
It is just as important for women with a disability to get a pap smear and adhere to a regular screening program, but it is more difficult for many women with disabilities to stick to a regular program. This is often because of transport difficulties, lack of assistance or the difficulty in finding health care professionals who can work with their needs (e.g. sign language or vision difficulties).
It is also common for women with severe difficulties to be overlooked for pap smears because other medical problems take the primary focus.
Pap smears are very important for women with a disability and a regular checking program should be achieved to ensure protection from cervical cancer.
Women over 70
Pap smears are recommended up to the age of 70. If women have had normal tests for at least the five years before they turn 70 then they are no longer required after this age. This is because there is minimal risk for women to develop cervical cancer after having regular tests without abnormalities throughout the sexually active lifespan.
However, if women prefer to continue pap smear tests after this age, they may discuss this with their doctor as it is possible to continue performing the tests if desired.
There are some studies that show that the HPV test results can show clearer results in severe cervical cell abnormalities. As a result, taking both tests is also advisable to find cervical abnormalities.
Pap smears should be performed every two years on sexually active women over 18 and this includes women who have been sexually active in the past. Many countries have set up registers for women and they send reminders. If women adhere to this program and maintain regular checks, then abnormalities should be picked up in the early stages and this will lead to detection of cervical cancer.