Cervical Cancer
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Pap smear

• The health professional uses a wooden spatula and brush to remove a few cells from the surface of your cervix.
• The cells are then placed on a slide and sent to the laboratory for examination.

Dr. George Papanicolaou, 1928

Purpose

• To detect abnormal cells in the cervix
• Part of this examination includes pelvic and internal vaginal examination to detect size and placement of uterus, ovaries and any abnormalities (i.e., fibroids, cysts, masses)
• Part of preventive health care
• May be done yearly - talk to your health care provider

Who should have a pap smear

• Anyone who is sexually active
• Females who have many partners
• Females who are heavy smokers
• Anyone who has menstrual problems, e.g., unusual pain, abnormal bleeding, abnormal vaginal discharge
• Females on contraceptive or hormonal replacement therapy
• Daughters of D.E.S. (diethylstilbestrol) mothers
• Potential/actual history of Human papiloma virus, warts or herpes
• Females with past history of cervical cancer

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Frequency of pap smears

• Determined by health care provider
• Once per year if on birth control and/or sexually active
• after three normal “Pap” tests (reports as satisfactory for evaluation) at one-year intervals, screening should be continued every two years until age 70
• Post hysterectomy for cancer of uterus: yearly for rest of life - Pap taken from vaginal vault
• More frequent test for high risk clients

Client history

• frequency and duration of menstrual cycle
• any spotting or bleeding between periods
• date of last menstrual period
• onset of menstruation
• any discomfort/bleeding after sex
• unusual pain or itching in genital area
• client or family medical problems
• present/past use of birth control and any problems
• present medication use

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Client instructions prior to pap smear

• no food or drink restrictions
• client must be in middle of menstrual cycle or post menopausal
• no douching, no insertion of vaginal medication or tampons, no sexual intercourse for 24 (preferably 48) hours prior to Pap smear

A vaginal speculum in place

Pap results

• Normal
• Abnormal

Dysplasia

• abnormal growth in the cells of the surface layer of the cervix
• cells do not mature in the proper way
• is not cancer
• health care provider will recommend another Pap smear every 3-6 months
• further investigation and/or treatment may be required
• women of all ages who are, or have ever been, sexually active should be screened
• after three normal “Pap” tests (reports as satisfactory for evaluation) at one-year intervals, screening should be continued every two years until age 70.
• if there have been four normal “Pap” tests in the previous ten years, screening may be discontinued

NOTE: These recommendations do not apply to those women who have has previous abnormal “Pap” tests

 

Cervical cancer mortality and screening in  Ontario in the 90s - Profile by Age Group

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