The cervix is at the lower part of the uterus (womb). The cervix joins
the uterus to the vagina. Cervical smear (the Pap Smear named after its
inventor, Dr. George Papanicolaou in 1920s) is a quick and simple test
for women to detect abnormal cell changes in the cervix, which may progress
to cancer if ignored.
Cervical cancer is preceded by the development of abnormal cells in the
cervix. If left untreated, these pre-cancerous cells may change and become
cervical cancer over five to ten years. Women with pre-cancerous lesions
do not have symptoms. Cervical screening aims to prevent cervical cancer
by detecting and treating these abnormalities. Treatment of pre-cancerous
lesions has a cure rate that is close to 100%.
Remember that the cervical smear is a screening test for detecting early
abnormal changes in the cervix. When such changes are found, they can
be treated before cancer develops. It is NOT a diagnostic test for cervical
cancer. A screening test is a test to be done at regular intervals to
detect early abnormal changes when an individual has no vaginal symptoms.
About 90% of cervical smear results are normal. If abnormal cells are
detected on the cervical smear, further tests are needed to see whether
the changes are serious or not. Simple treatment is often done as an outpatient procedure and will prevent cancer from developing. At this stage, treatment is usually
more simple and successful. If these early changes are left untreated,
they may progress to invasive cancer. Abnormalities picked up by a screening
test should be confirmed by a diagnostic test.
Preparation for Smear Taking
You should avoid having the smear test when you are menstruating. Two days before the test, you should avoid vaginal douching, use of spermicide, vaginal medicines and sexual intercourse as these may hide or wash away abnormal cells. If you have unusual vaginal discharge, you should consult a doctor and have the infection treated before having a cervical smear.
Smear Taking Procedure
Before the smear is taken, you may be briefly interviewed about your health and lifestyle. Doctors and nurses who participate in the Cervical Screening Programme will seek your consent for registration with the Programme and transfer of your personal data and test results to the Cervical Screening Information System which is a computerised central registry maintained by the Department of Health.
The cervical smear is a very safe test that only takes a few minutes. The doctor or nurse will insert an instrument (called speculum) into your vagina to allow visualization of your cervix which is located deep inside the vagina. A small piece of wooden spatula or plastic brush will then be inserted through the speculum to obtain some cells sample from the surface of the cervix. Afterwards, the cells sample will be smeared onto a glass slide or transferred to a bottle of liquid for preservation. The speculum is removed and the test is finished. The specimen will then be sent to the laboratory for examination under microscope.
Sometimes, your doctor may also perform a vaginal examination after taking the smear. This examination can help to detect any abnormality in your genital organs.
You should not feel any pain during the test if you are relaxed, but some women may feel mild discomfort which may be reduced by taking slow, deep breaths. Tell the doctor or nurse to stop if you feel very uncomfortable during the test.