Pap Tests! No Doctor or Nurse Practitioner?

• Fall 2011 Clinic Information
  

Call to book a FREE Pap test with a female nurse practitioner:
613-283-2740 or 1-800-660-5853

For information on Cervical Cancer and HPV.

For current information on Human Papillomavirus (HPV) visit Cancer Care Ontario.

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.

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 - three 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.

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