Pap test, or Pap smear: what it is and when to do it
The importance of the Pap test (Pap Smear): like other cancers, cervical cancer can be detected at an early stage, when it may still only be present in the form of treatable precancerous lesions
Routine check-ups are therefore not only important, but are also essential in order to be able to act on the cancer when it is still in its early stages.
Foremost among these examinations is the pap test, which detects the presence of a tumour or precancerous lesions by analysing the cells of the cervix
It is a simple, fast and painless examination that is used by the specialist to detect viral, bacterial or fungal infections.
What is cervical cancer?
Cervical cancer is caused by a virus, the Papilloma virus (HPV), which is transmitted through sexual intercourse.
Infection does not necessarily lead to the development of a tumour, as the body is able to fight the virus in about 90% of cases, and the presence of cellular changes does not necessarily indicate the presence of cancer.
However, there remains a 5% chance that the mucosal changes caused by HPV infection will develop into cancer.
This is a lengthy process, which can take up to ten years, and therefore the pap test is essential to check for precancerous lesions in advance and prevent them from leading to cancer.
When we talk about the pap test, therefore, we are talking about a fundamental preventive tool, which makes it possible to detect precancerous lesions that, at an early stage of the disease, do not cause any visible symptoms in patients.
For this reason, the pap test saves the lives of many women every year and is considered the first screening test for early diagnosis of cervical cancer.
When to do the pap test?
There is no specific age at which it is recommended to have the first pap test: it is in fact an examination linked to the sexual activity of the patient and, therefore, it tends to be recommended from two years after the first sexual intercourse.
A healthy patient, who has no risk factors and has never tested positive for HPV, can have a pap test every three years.
Those with a previous history of HPV or established risk factors should have a regular annual test.
In any case, it is always advisable to follow the advice of one’s specialist, who will be able to indicate the best way forward, also in relation to the patient’s medical history.
In the three days preceding the pap test, the patient should abstain from sexual activity, as the presence of residual spermatozoa could interfere with the reliability of the result.
Ovules and vaginal douches, which tend to conceal the presence of cellular changes, should also be avoided, while oral contraceptives and intrauterine coils are not contraindicated.
The Pap test cannot be performed during menstruation, so it is advisable for the patient to indicate the window between the two menstrual flows when booking.
In the periovulatory period, a higher quantity of cells is taken for examination.
Women who have passed the first trimester of pregnancy can also undergo a Pap test. It is a non-dangerous examination, which does not present any risks for the foetus or the mother.
Pap test: how is it performed?
The Pap test is a simple examination that lasts a couple of minutes, does not cause any pain to the patient (at most a slight discomfort) and is carried out as part of a routine gynaecological examination.
The gynaecological specialist holds the cervix apart with the speculum, the special goose-bill instrument, and removes cells from the cervix with a thin stick.
The cells are then fixed on a suitable slide and sent to the laboratory for analysis. The result usually arrives in 10-15 days.
What does the result of the pap test mean?
If the result of the pap test is negative, it means that the sample did not show any cellular alterations and that the patient can undergo the examination again within the time frame established with the specialist (as we have said, normally between 1 and 3 years).
If, on the other hand, the Pap test is positive, this means that cellular abnormalities are present and that the patient will have to undergo a further examination, the HPV test, which is carried out as a simple vaginal swab and detects the presence of the virus DNA in the genital tract.
The HPV test confirms HPV infection but does not detect the presence of a tumour.