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As cervical cancer is the third most common cancer among Jamaican women, regular pap smears, the screening process for this disease, are essential for women's health. Below we discuss what makes pap smears so critical and whether or not you need to get one!
But first, what is a Pap Smear?
A pap smear is a screening procedure where your doctor uses a small brush or wooden spatula to (gently) scrape cells from your cervix and the surrounding area. These cell samples are then checked under a microscope for cervical cancer cells or cell abnormalities that could lead to cervical cancer (also called precancerous cells).
Why are they important?
When found in its earliest stages, cervical cancer is considered to be easy to treat and curable. Regular pap smears can help you to catch cervical cancer before it becomes more challenging to treat.
As said above, pap smears can also detect precancerous cells. Obstetrician Gynaecologist, Dr Robyn Khemlani, advises, “if you have abnormal cells, further tests are done to determine whether the cells are cancerous. If needed, a procedure may be done to destroy the abnormal cells and reduce your risk of cervical cancer.”
Do they hurt?
While pap smears can feel uncomfortable, they should not be painful. From Dr Khemlani, “If you are getting your first Pap smear done, it may feel a little uncomfortable because it’s a new sensation that your body is not yet used to. People often say it feels like a small pinch, but everyone has a different threshold for pain.”
Dr Lesley Chin agrees, saying, “Pap smears do not hurt, but they can be extremely uncomfortable.”
To minimize discomfort, Dr Khemlani advises that you pee before the test, while both she and Dr Chin advise patients to try to relax.
Dr Khemlani: “If you are scared, you may ask your doctor to use a small speculum,” and remember, “The entire thing usually takes less than a minute.”
What can pap smears NOT diagnose?
While pap smears can also help to diagnose other conditions, such as cervicitis or inflammation of the cervix and certain infections, it’s critical to remember that they are not used to diagnose most sexually transmitted diseases (STDs). Consultant obstetrician gynaecologist, Professor Horace Flecher, C.D., explains why:
“Pap smears may diagnose some STDs or STIs, but they are unreliable for that purpose. More sensitive tests are available to diagnose STIs and STDs.”
As such, testing for STDs and STIs is still essential, even after a normal pap smear result.
So who needs pap smears?
In general, women don’t need to start pap smear screening before age 21 and can typically stop at 65, when they meet certain conditions.
Depending on your circumstances, your obstetrician-gynaecologist may recommend starting before 21 and continuing beyond the 65-year age limit. For example, as cervical cancer is most commonly caused by the Human Papillomavirus (HPV), a sexually transmitted disease, sexually active teenagers may be recommended to get a pap smear screening alongside HPV testing.
That being said, it’s important to note that cervical cancer can be caused by other factors, like smoking or genetics. With this in mind, Professor Fletcher notes that after 21, pap smears are necessary, whether you're sexually active or not.
How often do I need one?
While many U.S. experts recommend getting a pap smear once every three years, Professor Fletcher recommends going once every two years.
“Our populace is at a higher risk of developing cervical cancer due to a number of factors. For example, there are different strains of HPV. While less common than high-risk strains like types 16 and 18, HPV Type 45 is more common in the Caribbean than in the U.S..”
HPV Type 45 is the third most common genotype in invasive cervical cancer.
Professor Fletcher notes that where a previous pap smear result leads to a cervical cancer diagnosis or if precancerous cells were identified, you will likely need to repeat screening at least once a year.
Other reasons for more-frequent pap smears include a history of smoking, contracting HIV, a weakened immune system and exposure to diethylstilbestrol (DES), now rarely used, that was prescribed to pregnant women between 1940 and 1971.
Do you need a pap smear? Call us at 876-926-6067 to book an appointment with any of our obstetrician-gynaecologists!
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