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Smear Tests

Almost all of us harbour some trepidation about having a smear test. It’s natural to feel exposed about exposing ourselves to a stranger, and there’s also the additional anxiety the evaluation may show up a worrying effect. But it’s up to us all to take accountability for our own well-being.

A smear taken often can find the first precancerous changes, which can be treated quickly so the cancer never grows. As cervical cancer is among the few cancers over which we can use some positive management, it’s insanity to let a couple of minutes of humiliation to prevent us having routine checks. It’s a really fast process and before you know it, it’ll be time to go home.

Were You Aware?

• The human papilloma virus (HPV) increases the threat of cervical cancer.
• 95 percent of women with cervical cancer carry HPV.
• HPV is symptomless in many girls.
• Having many sexual partners places you at risk as it increases your chance of being exposed to HPV.
• Cervical cancer won’t have time to develop if you’ve got regular smear tests.

A cervical smear, also known as a Pap smear after the physician (Papanicolau) who devised it, is done during a pelvic examination. It’s used mainly to detect precancerous and cancerous cells on the cervix – the neck of the uterus.

It finds quite early abnormal changes in the cells of the cervix, which can be ruined thereby preventing cervical cancer from developing. Cancerous change is even more likely if you’ve got several partners. Promiscuous sex additionally raises the danger of being infected with HPV, the virus that encourages cervical cancer.

The evaluation offers a 95 percent chance of finding CIN (abnormal cell changes which, if not detected and treated, could become cancerous).

What’s The Cervix?

The cervix is little, cylindrical, several centimetres in length and forms the lower part and neck of the uterus. The cervix dips down into the vagina. Running through the center of the cervix is a duct by which sperm pass from the vagina into the uterus on their way to fertilize an egg and through which blood passes during menstruation.

Who Should Have Smears?

Cervical smears should be performed on all girls once they start having intercourse and then every three years up to the age of 65. The evaluation is, in addition, significant for girls who have or have had infection with the human papilloma virus (HPV). A smear may incidentally find sexually transmitted diseases.

When And Where Is It Done?

A girl should have a cervical smear within a year of her 20th birthday. Cervical smears may be performed by GPs or Good Girl or Family Planning Practices. You shouldn’t be menstruating or have had intercourse within 24 hours of having your evaluation as blood and semen make the result unreliable. Ideally you should be at mid-cycle to get the finest quality smear.

How Is It Done?

You lie on your own back with your knees flexed. A warm speculum is passed into the vagina to divide the walls so the physician can see your cervix.

A wooden spatula is wiped across the cervix to accumulate cells, and the smear is transferred to a glass slide and sent to a lab’. The whole thing takes less than a minute and, although uncomfortable, isn’t distressing. The results should be accessible within 6 weeks.

The Results

Effects of a smear test are classified into three groups:
• Negative gives you the all clear.
• Moderate dysplasia or CIN I means you have some disease and should be screened more often.
• A positive smear test, although not consistently showing cancer, means there’s a detectable change in the cells necessitating additional investigation.
The table below gives you a complete run down of the type of results you’re likely to get and what you’ll need to do in result.

Result

Action
NegativeNo follow-up needed: next smear in three years’ time
Mild dysplasia or CIN IAnother smear in no more than 6 months’ time
Moderate dysplasia or CIN IIColposcopy
Severe dysplasiaColposcopy

Colposcopy

Colposcopy is a straightforward, noninvasive process and can be used as a treatment together with a diagnostic tool following an abnormal smear test. It needs no anaesthetic and can be done in your gynaecologist’s operation or outpatient clinic.

The colposcope, a type of microscope, is set at the entry to the vagina. The physician examines the tissue to identify the exact area of abnormal cells. (A smear test doesn’t nail this precisely.) He’ll subsequently remove the speculum slowly so he can scrutinize the vaginal walls.

Strange cells inside the cervical canal can’t be found with a colposcope. If these are supposed, a cone biopsy (in which a cone of cervical tissue is removed) will be advocated.
Places supported as unusual by biopsy are treated by electrocoagulation or laser (both use heat to destroy tissue), by cryosurgery (which uses cold to destroy tissue) or may be removed by diathermy loop excision (OLE). Treatment may be carried out at the exact same time as colposcopy if the abnormal area is modest and well defined. If a girl is pregnant, treatment is typically delayed.

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