Cyprus Smear Test

What is Smear Test?

Smear Test (Pap Test) is an important test used for cervical screening. Smear test enables early diagnosis of lesions, which may get cancerous, so that they can treated when they can.


How is Smear Test Done?

Smear test is a simple and painless test. The best time to do it is between days 10 and 20 of menstrual cycle. This test should not be done during menstrual period. Examination instrument is used to gently open the vagina for test so that cervix can be seen. Afterwards, small brush is used to take a sample of cells from the cervix and the process is done.

Cells taken are sent to a pathologist and analyzed under microscope. They check if there is any abnormality. The purpose of the analysis is to detect possible cancer besides diagnose lesions which are not cancerous but may get cancerous and which are treatable. In case of positive result, which means, if there are abnormal cells, doctor may ask you to get HPV test and colposcopy.

One should not have sexual intercourse, wash her vagina and administer medicine or cream into her vagina 2 days before the test will be done. In case of genital infection, it should be treated first and then smear test must be done.


What is the Significance of Smear Test?

Abnormality and changes may occur in the cervical cells. Such cells suggest cancer may develop in the future.

The purpose of smear test is to detect cell abnormalities before they get a chance to turn into cancer. As such, patient can get treatment easily before it turns into cancer.

The main reason for normal cervical cells to become abnormal is the presence of Human Papilloma Virus (HPV).

Human Papilloma Virus (HPV) cause genital warts and development of abnormal cervical cells. HPV is transmitted mostly sexually. In our country, recently there has been an increase in HPV-related warts and abnormal cells that cause cervical cancer.

Smear test enables early detection of such changes which may lead to cancer and it is an effective, easy and painless procedure. Smear test provides the opportunity to diagnose changes in cells before they turn into cervical cancer. After the treatment, female patient becomes completely healthy and can get pregnant. Early diagnosis ensures that one does not have to undergo operation for removal of uterus, radiation or medication.


When Should One Start to Get Smear Test Done?

One must start to get smear test done 3 years after the first sexual intercourse or after 21 years of age. It is recommended that women who are aged between 21 and 30 years must get it done once a year and women who are aged over 30 years must get it done every 2 to 3 years of results of first 3 smear tests are negative.

However, those who are HIV positive, who has a weak immune system, take estrogen supplements, get organ transplantation and undergo chemotherapy and cortisone treatment must get screening done more frequently.


What are the Reasons for Development of Abnormal Cervical Cells which indicate Possible Cervical Cancer in the Future?

The reasons which increase the possibility of developing abnormal cells that indicate possible cervical cancer in the future are as follows:

  • Sexual intercourse at an early age
  • Sexual intercourse with more than one partner
  • History of sexually transmitted disease (such as gonorrhea, syphilis and herpes)
  • Genital warts
  • Bad genital hygiene
  • Smoking


Does One Have to Get Smear Test Done Despite Getting HPV Vaccination?

There are several different types of Human Papilloma Virus. Vaccination is effective for some types of it. The vaccine is effective for the most frequently encountered types which are 6-11-16-18; however, lesion may develop due to other types which are rarely seen. Therefore, even those who get vaccination must get Smear Test done.


What are the Further Tests That are Done in case of Abnormal Pap Smear Test Result?

As smear test is a screening test; colposcopy, biopsy and cervical curettage may be required for further examination in case of suspected result. In colposcopy, vagina is gently opened by use of an examination instrument and upper part of the vagina and cervix are examined in detail through microscope. Patient may be asked to get HPV test done before this procedure. If abnormal areas are detected in the cervix as a result of colposcopy, biopsy may be required. Biopsy taken is sent to pathologist for analysis.


How Are Patients with Abnormal Smear Test Result Treated?

In colposcopy, suspected areas are frozen or removed by use of laser. This treatment is effective for destructing lesions which may get cancerous and preventing cancer. Patient must be monitored regularly after colposcopy.

Risk factors for cervical cancer and lesions which may get cancerous:

  • Aging
  • Race (risk is higher in people of color)
  • Asian, African and Latin American origin
  • Low socio-economic status
  • Low academic background
  • Polygamy
  • First sexual intercourse at an early age
  • Smoking
  • Using contraceptives for a long period of time
  • Folic acid, vitamin A and vitamin C deficiency
  • Having had several pregnancies
  • Getting pregnant at an early age
  • History of sexually transmitted Herpes Virus and HPV
  • HIV infection
  • Exposure to estrogen in the womb
  • Not getting smear test done periodically
  • Immune system deficiency
  • Genetic factors
  • Following a diet that lacks vegetables and fruits
  • Being overweight


Importance of Control after Smear Test

If abnormal cervical cells which may get cancerous are detected as a result of smear test, it is really important to get controls done as frequently as doctor prescribes. If a patient neglects regular controls, there is a risk that it may get cancerous

  • Within 10 to 14 years in case of slight abnormalities
  • Within 1 to 5 years in case of severe abnormalities.

Therefore, it is really important to get annual routine gynecology controls and smear test done.

The important factors that play a role in healing or complete disappearance of cell abnormalities that may get cancerous are as follows:

  1. Strong immune system
  2. Healthy diet
  3. Staying away from stress
  4. Doing sports
  5. Getting enough sleep
  6. Staying away from chemical substance and smoking
  7. Monogamy


How Frequently One Must Get Test Done?

Every woman must get gynecological examination done once a year even she does not have any health problem.

During routine gynecological examination, it is checked whether there is

  • wound, redness and change of color in cervix
  • infection (fungus, bacteria and HPV virus)
  • myoma, polyp and thickening of the endometrium
  • ovarian cyst and decrease in the number of eggs.

If smear test result is negative, there is not any need to get test done every year. It can be done every 3 years.

In some cases, smear test must be done more frequently. These are as follows:

  • Detection of suspected cells / abnormal cells which may get cancerous in the smear test
  • Failure to analyze smear test completely
  • Absence of enough cells for analysis in the smear test


Does Smear Test Break Virginity? Can Virgins Get Smear Test Done?

As HPV is a sexually transmitted virus, there not any need for virgins to get smear test done. Virginity may get broken during smear test.


Is There an Age Limit to the Test?

One must start to get smear test done after the first sexual intercourse. There is not any need to get smear test done after the age of 65.


What Does One Should Pay Attention to After the Test?

Vaginal bleeding that is similar to light spotting is normal after smear test. One can have sexual intercourse, do sports etc. after the test. There is not any restriction. Result must be monitored definitely after test and one must make sure that it is analyzed by the doctor.


Can Pregnant Women Get Smear Test Done?

During pregnancy, the ideal time to get smear test done is within the first 3 months. However, a woman can get smear test done during the entire pregnancy. Light bleeding may occur after smear. It should not concern you.


Does Smear Test Cause Any Harm?

Smear test does not cause any harm. On the contrary, they are useful as they enable early detection of uterine and cervical cancer.


HPV Vaccine

One can get HPV vaccination from the age of 12 to 45 years in order to be protected from Human Papilloma Virus that cause cervical cancer. In Europe, all of the young girls get vaccination for free as of the age of 12 years. Unfortunately, one has to pay for it in our country. It is done in 3 doses. This vaccine ensures protection from 4 types of virus that are encountered most frequently.


What is Colposcopy? Why is it Done?

It is a procedure for close examination of cervix by use of a large magnifying glass. It is not a painful procedure. It is done in the examination room without anesthesia. During the procedure, the patient is all awake and lies in gynecological examination position. If abnormality or change is detected in cells as a result of magnification and evaluation, biopsy can be taken and sent to a pathologist for analysis. The right method of treatment is decided depending on the result of pathological examination.


What are the Symptoms of Cervical Cancer?

Lesions do not cause any symptoms before cancer. Therefore, it is really important to get the test done in absence of complaints. The disease starts to cause symptoms after it turns into cancer. Bloody vaginal discharge with bad odor, bleeding and pain during sexual intercourse, unexpected bleeding between menstrual periods and menstrual periods longer than average are among important symptoms.

It is important to get smear test done regularly for protection from cervical cancer.