Routine Screening (Pap Smear)
The Pap smear takes its name from Dr Papanicolaou, who developed the staining technique used to identify cells that may be undergoing malignant change. This simple but important test helps detect women who may be at risk of developing cancer of the cervix, which is the entrance to the womb.
During the procedure, the cervix is gently accessed using a speculum. Cells are collected from the area most prone to change using a small brush or wooden spatula. The sample is then sent to the laboratory, where it is stained using the Papanicolaou technique and carefully examined by a cytologist.
Cervical cancer typically develops slowly and follows a fairly predictable pattern. In many cases, early cellular changes resolve spontaneously. However, between 5% and 15% of abnormal changes may progress over time if left untreated. Regular screening allows these changes to be identified and managed long before cancer develops.
Who Is at Risk of Cervical Cancer?
All sexually active women are potentially at risk of cervical cancer.
Beginning sexual activity at a young age, particularly during adolescence, increases risk because cervical cells are still maturing at this stage. These younger cells are more susceptible to carcinogens, especially certain viruses that can be transmitted through sexual contact.
The viruses most commonly associated with cervical cancer are specific types of the Human Papillomavirus (HPV), often referred to as the wart virus, and the Herpes virus.
How Often Should a Pap Smear Be Performed?
Your first Pap smear should be done approximately one year after becoming sexually active.
If the results are normal, the test should be repeated annually for the next two years. This is important because the Pap smear is not perfectly sensitive and may detect only about 40% of abnormal cells on the first test. Repeating the test improves accuracy and safety.
If you are in a stable, monogamous relationship and your results remain normal, screening can usually continue at three-year intervals, unless your doctor advises otherwise.
If you are not in a monogamous relationship, your risk is higher and annual screening is recommended.
If viral changes or pre-malignant cells are detected, the smear may need to be repeated within three to six months. You may also be referred for a colposcopy, which is a more detailed examination of the cervix using a specialised microscope.
Not all pre-malignant lesions require treatment. When treatment is necessary, it is usually straightforward and does not affect fertility.
Regular Pap smears remain one of the most effective ways to prevent advanced cervical cancer. Although it may feel like a small inconvenience, it is an important and empowering step in protecting your long-term health.