Get your smear so you're in the clear!
Ok mujeres, of course, we have to review this because even if everyone doesn’t know what a Pap smear is, I’m sure you all have heard of one.
Quick anatomy update because we have to get the basics out of the way to really learn from and understand this blog. The cervix is the opening into your uterus. If you put your fingers inside your vagina you may or not feel it; sometimes it feels like a firmer lump. I have had patients feel it and freak out; don’t worry that is normal and is your cervix. But if you are not sure, come in to double-check. Your uterus is the muscular organ where a baby grows during pregnancy and is where the blood comes from during your period. Finally, your ovaries are connected to your uterus via ligaments and it is where an egg is released from during a menstrual cycle or where ovarian cysts can form.
Also, a female has three orifices or holes. The first one is your urethra or pee hole where your urine comes out of. The second one is your vagina where your blood comes from when you are on your period and where a baby comes out of during birth and the third is your anus. Yes, men only have two, a urethra and an anus. 😊 Feel free to refer to this anatomy lesson from time to time. I just want my mujeres to know what’s up!
So why is It Called a Pap Smear?
The test was invented by a Greek physician who immigrated to American named Dr. George “Pap”anicolaou in the 1940s! Let’s give it up for Dr. Pap who basically saved thousands of women’s lives from cervical cancer and continues to do so every day.
How is a Pap smear performed?
The Pap smear is when your provider takes a sample of cervical cells with a small brush or two and sends it to the lab for a pathologist to read the smear. I know I make it sound easy and I understand it can be painful for some mujeres, but remember you are doing this for your health. You can also ask your provider to test for vaginal infections that can be run off the same vial so it is a win-win situation; one sample for multiple tests. Score! But remember the Pap smear doesn’t automatically test for other vaginal infections so please ask. It is preferred that you are not on your period because the red blood cells can obscure the smear from being read by the pathologist and I know you don’t want to do this again so soon if you can avoid it!
FYI- every pelvic exam is not for a Pap smear, but every Pap smear requires a pelvic exam. That might change in the future though!
What does a Pap smear test for?
I want to make it clear though that a Pap smear is a screening test only for precancerous cervical cells or cervical cancer. Not uterine or ovarian cancer!
Important side note mujer: Just because you have an abnormal pap does not mean you have cervical cancer! I repeat, YOU DO NOT HAVE CERVICAL CANCER!
Even though the uterus and ovaries are also female organs and connected; at this point, there is not a screening test for these types of cancer. Most women will have abnormal uterine bleeding which can be a sign of uterine cancer especially if she has gone through menopause and at times those cells can be seen on a pap smear. Unfortunately for ovarian cancer, it is sometimes detected in the later stages yet symptoms could be abdominal bloating, pain and feeling full fast after eating. Again, make sure you and your friends know it is a screening test for cervical cancer only! That is the main point of this post today. It will usually take about a week to get your results.
How often do I need a Pap smear?
First things first! An annual exam is different from a Pap smear! Women should visit their provider annually for physical exams, but the newest guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP) is for low-risk women to begin screening at age 21 regardless if she has had sex or not. Why? Because at a young age you have a high chance of exposure to HPV that can cause abnormal Paps, but the key is these lesions are likely to be transient and regress especially when you are young. The exception to start before age 21 is if the woman has HIV or is otherwise immunocompromised with a condition that weakens her immune system.
For mujeres aged 21-29 years, she should be tested with cytology or check the cells alone every 3 years. For mujeres aged 30-65, co-testing with cells and HPV testing every 5 years is preferred. Even with this recommendation, I find myself co-testing my patients every 3 years; but of course, if something in their history has changed then I may consider performing the Pap annually for some time after we discuss it and make a decision together.
I know for almost every one of you, that guideline seems weird because everyone is always told to go get their pap smear every year. Well these guidelines are based on a large study with thousands of women and now we know if your HPV test is negative then chances of having a high-grade lesion or a lesion more likely to turn into cancer is very low and this decreases the risks of false positives, extra procedures, expense, and anxiety that could be caused by annual screening.
Also, the recommended age to stop screening is at age 65 depending on your history; but I tell my patients in this age group if you have a new boyfriend though we still have to consider performing the Pap because of possible exposure to HPV even later in life. Still, talk to your doctor and together you can decide what screening guideline is best for you. I hope this quick and concise post clears up Pap smears.
Read it, Learn it, Share It. Until next time mujeres.
Dr. Erica