In India, out of all the health-related complaints, female health problems receive the least attention. Female health issues are most commonly neglected or considered to be a part of the normal physiology, thereby receiving limited or no medical attention and treatment.
Unhygienic living conditions, poor nutritional status, limited access to health services and inability to maintain hygienic conditions during menstrual cycles make Indian women susceptible to a wide variety of infections of the reproductive tract.
Cervical cancer is one of the commonest affections of the reproductive tract caused due to Human Papilloma Virus (HPV) infection. Screening for precursors of HPV by means of Papanicolaou (Pap) smears is known to substantially reduce the incidence of cervical cancer.
During the last few years, there has been an increase in awareness programs for women all over the country regarding the importance and uses of a Pap smear test. This article will let you understand what a Pap smear test is, the purpose of doing the test and what happens after an abnormal Pap smear.
A Pap smear is also known as cervical cytology or Papanicolaou smear. This test involves microscopic examination of cells scraped from the cervix to detect the presence of pre-cancerous condition and cancer of the cervix or infections.
To begin with a little bit of anatomy, the cervix is normally made up of two types of epithelial cells at different locations.
The junction at which the two canals meet is called the squamocolumnar junction. The sample for a Pap smear test is collected from this site.
The Following Types Of Cells Can Be Visualized On A Normal Pap Smear
Medical terminologies and abbreviations can sometimes appear complicated and even difficult to understand unless explained by the doctor. Some common terms used for reporting a Pap smear test are given in the table below:
Pap Smear Findings | Interpretation |
Atypical squamous cells of undetermined significance (ASCUS) | Abnormal squamous cells present but do not fit into the criteria for squamous intra-epithelia; lesion (SIL) |
Low-grade squamous intraepithelial lesion (LSIL) | Mild abnormal cells or changes in tissues attributable to Human Papilloma Virus (HPV) infection |
High-grade squamous intraepithelial lesion
(HSIL) | Moderate to a severe abnormality in squamous cells or tissue changes |
Carcinoma | High possibility of cancer of cervix and needs evaluation. |
Presence of atypical cells on microscopic examination suggests an abnormal Pap smear. This can occur as a result of cervical cancer from infection of the cervix. Causes for an abnormal Pap smear besides HPV are
It is essential for all sexually active women to undergo a Pap smear test annually. If the smear appears to be abnormal, then it is repeated at an interval of 3-6 months. Three consecutive abnormal results is an indicator for further evaluation.
Pap smear test is capable of detecting cervical cancer or pre-cancerous condition of the cervix at an early stage. When found early, the chances of being cured are significantly high.
The following set of tests may be done after an abnormal Pap smear test depending upon the patient’s age and the first Pap smear test result.
After an abnormal Pap smear test, if further studies too suggest the presence of abnormal cells within the cervix, the treatment can be of the following two types:
In the excisional treatment, the abnormal cervical tissue is excised or removed and sent to the laboratory for study. The laboratory then reverts back with results whether cervical cancer is present and how severe it is.
Types of excisional treatment are:
In ablation, abnormal cervical tissue is destroyed. In this type of treatment, the abnormal tissue is not sent to the laboratory.
Types of ablative Treatment Are:
It is generally recommended for women to begin Pap smear testing right from the age of 21 years. A Pap smear test should be repeated every three years in women in the age group of 21 to 65 years.
Pap smear tests can be stopped if they are negative for women up to the age of 65 years or if the woman has undergone hysterectomy (surgical removal of the uterus).
Although the Pap smear test is one of the best screening tools of cervical cancer, yet, there are chances of receiving false-positive or false-negative results.
Dr. Himanshi is a Homoeopathic consultant and currently working as a lecturer in Post-graduate faculty of Homeopathy, Parul University, Vadodara. Completed BHMS and MD in Homeopathy in January 2018 and also has a clinical experience of about 6 years. Personal interests include reading, spending time with family and traveling.
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