Everything To Know About Pap Smear Test

What is a Pap Smear Test?

A Pap smear test is a screening procedure for cervical cancer. It checks the presence of precancerous or cancerous cells on the female’s cervix (the opening of the uterus). It is the most effective method to detect and diagnose cervical cancer.

A Pap smear, also known as a pap test, is essentially not a painful process but can cause spotting or light bleeding after the procedure. Pap smear neither causes any long-term side-effects nor any severe complications.

During a pap smear test, the doctors scrape a couple of cells from the cervix gently and examine for any abnormal growth. The whole procedure is performed at the gynaecologist’s clinic.

Why are Pap smear tests done?

Pap smear tests are used for early detection of cervical cancer. Once women are sexually active, they are at a risk of getting contracted with HPV (Human papillomavirus) that are responsible for making the cells in the cervical area cancerous. Thus, screening for the virus every couple of years can lead to early diagnosis and thus, the patient can seek early treatment before it gets severe.

Other than getting contracted by HPV, there are various other factors that can increase the likelihood of developing cervical cancer.

Pap-Smear Risks & Complications

Risk factors

• Suffering from AIDS
• Smoking
• Giving birth to three or more children
• Having multiple sexual partners Prolonged use of birth control pills.

Risks and Complications that can occur after Pap Smear Test

Pap smear test is a safe procedure to undergo. There are absolutely no complications associated with pap smear tests. Medical experts have found no risk or long term side effects associated with such tests.

However, it is common to experience a small amount of spotting or mild vaginal bleeding for a few days after a pap smear. There is nothing to be worried about as it is likely to resolve on its own within a couple of days.

This generally occurs as the cervix gets irritated and causes mild discomfort. However, pap tests are an important measure to detect the presence of precancerous cells in the cervix so that it can be treated early and women of reproductive age remain healthy.

Although not a risk, a common anomaly to a pap smear test is the result being ‘false-negative’. The result being ‘false-negative’ refers that the results are not ‘abnormal’ even though the doctor detects some changes in the cervix. The results may be ‘false-negative’ due to the following factors-

Insufficient sample of cells were collected
Due to inflammation or blood, the malignant cells remained undetected.
In such cases, the patient has to go for another test.

How often should one get a Pap Smear Test?

As per the recommendation of the American College of Obstetricians and Gynecologists –

Women belonging to the age group of 21-29 years should have a pap smear once every three years.
Women belonging to the age group of 30-65 years should have a pap smear and a test for HPV once every 5 years.
There are no restrictions per se and you can have pap smear tests as many times you want. Generally, a woman above the age of 21 should get regular pap smear tests.

If the doctors suspect some aberrations in the results of the pap smear test, they can suggest doing the test more often regardless of age. Gynaecologists suggest that the frequency of pap tests to be performed is dependent on the following factors-

Medical history and ailments the woman has suffered in the past
Results of the last Pap test are ‘abnormal’ meaning there is the presence of precancerous cells or cervical diagnosis
An HIV infection
Smoking on a regular basis
Having a weakened immune system due to organ transplants, chemotherapy, or using corticosteroids on a long term basis

Myths and Facts about Pap Smear Test

Myth 1: Pap smear test can diagnose all types of cancer in the reproductive system.
No. Pap smear tests are specifically designed to detect the presence of cancerous or precancerous tissues in the cervix (opening of the vagina). The test cannot detect the same in other reproductive organs such as ovaries, fallopian tubes, uterus, etc.

Myth 2: Pap smear test is sufficient to treat cervical cancer.
Pap smear test is only used for diagnosing the presence of malignant cells in the cervix. For treating the condition, the patient has to undergo various treatment options including chemotherapy and surgery. Furthermore, women over 30 years should consider an HPV (Human papillomavirus) test along with a pap smear test to get the correct diagnosis.

Myth 3: I should get a pap smear test every year to detect cancer.
There is no need to go for pap smear tests every year. For those at average risk, doctors don’t prescribe them to go screening annually. Contrary to this myth, regular screening can result in more false-positives that can cause stress unnecessarily.

Myth 4: I have my HPV shot so I don’t need Pap smear tests.
Unlike other sexually transmitted diseases such as chlamydia, gonorrhea, etc. HPV can lie dormant for a couple of years and do not cause any

Pap Smear Treatment options & cost

What is the cost of Pap Smear Test?

In India, the cost of pap smear test can be as low as INR and can reach upto a maximum of INR. Thus, the average cost of pap smear test comes around INR. Remember that the actual cost of the procedure may vary as it is decided on a couple of factors. These factors include-

Consultation fees of the doctor
Location of the clinic
Number of follow up visits required during the entire course of treatment
Lab testing

How to prepare for the Pap Smear Test?

Preparation helps a patient have a hassle- free experience. Here are a couple of tips that can help you prepare for a pap smear test-

Refrain from having sex atleast 48 hours before the procedure
Avoid using or inserting any foams, creams, or medicines into the vagina
Make sure you are not on your periods while scheduling the test
Empty your bladder before the test
If possible, request the doctor to use a smaller sized speculum
Prepare a list of music that helps you relax during the procedure
If possible, ask the doctor if it’s okay to insert the speculum yourself
Arrange for someone who can accompany you to the clinic for support
Let the doctor know if you are on any other medications for some other medical conditions
If you follow the above tips judiciously, the results will be more accurate and there may not be the need to do another test.

What to expect during the procedure?

Here is a step-by-step explanation of the procedure of pap smear test-

• The woman has to first lie on her back.
• Next, the gynaecologist examines the external genital and rectal areas, including the urethra (the opening from where urine leaves the body), to make sure all parameters are normal.
• After this, the doctor inserts a speculum (an instrument which allows the gynecologist to see and examine the vagina and the cervix) into the cervix through the vaginal area (the birth canal).
• With the help of a small brush or swab, the doctor collects a small tissue from the opening of the cervix. The sample is then sent to the laboratory for further evaluation.

What do the results of a Pap smear test mean?

A Pap smear test results will say one of the following things –

The result is normal- No cancerous cells or HPV strains are found if the pap smear test result is normal. ‘Normal’ pap smear result indicates that the cells collected from the female’s cervix are not at all cancerous. The cells are normal and the woman does not need to do anything until the next pap test.

The result is unclear- An ‘unclear’ pap smear test result means that the gynaecologists are unable to confirm whether the collected samples from the female’s cervix are normal or malignant. If the results of a pap test are unclear, the gynaecologist may prescribe more tests right away to rule out any complications or severe problems. If required, the gynaecologist may ask the individual to come back in 6 months or so for another pap test.

The result is abnormal- ‘Abnormal’ pap smear test result means that the cells collected from the female’s cervix during the pap test look abnormal. Abnormal pap test results do not necessarily mean that the female has cancer. If the results of a pap test are abnormal, the gynaecologist will do more tests right away to figure out what should be done next.
There are various levels of malignant cells-

Atypia
Mild
Moderate
Severe dysplasia
Carcinoma in situ
If the pap test confirms unhealthy modifications in the cells of the cervix, the gynaecologist suggests doing more tests, like a colposcopy and biopsy.

Does a pap smear hurt?

No, a patient doesn’t feel any pain during pap smear tests. However, the patient may only feel a prickly sensation down there as an external object is slid inside the cervix.

The feeling is similar to that of a pinch, but since every person has a different pain endurance, the experience could be different for each individual. If the pain and discomfort is more than what you can endure, inform your gynaecologist without any further delay. Here are a few things that you can do to ease out the pain:

• Relax your shoulders
• Breathe slowly and deeply
• Relax your stomach muscles
• Loosen the muscles between your legs
• Follow your doctor’s instructions judiciously

Insurance coverage for Pap Smear Test

Pap smear tests are not covered by most of the medical insurance companies in India. The health insurance companies in the country explain that as this is an elective procedure that people choose to undergo, most of the health insurance plans do not offer any coverage. Furthermore, they also add that Pap smear is preventive as it diagnoses the presence of cancerous cells in the cervix. Thus, it is not performed for emergency conditions.

It is important to note here that the Pap smear test is an affordable procedure to consider. Moreover, clinics nowadays offer more than one option to finance the test. Thus, speak with the doctor or clinic staff regarding the payment option they consider as well as any additional benefits they provide within the quoted amount.

Recovery after Pap Smear Test

As pap smear is a diagnostic test, there is no recovery period. A patient can resume their daily routine immediately after the procedure. In case you are experiencing bleeding due to cervical irritation, avoid indulging in sexual intercourse or inserting a tampon.