Ladies, if you’re over 30, a pap smear is a must for cervical cancer screening

Cervical cancer is the most common cause of cancer-related deaths in India, so its screening is extremely important for women over 30. 
Don’t ignore the importance of a pap smear. Image courtesy: Shutterstock
Dr Mathangi J Published on: 24 June 2022, 23:24 pm IST
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For those caught unaware, pap smear, or simply a pap test, is a screening test for cervical cancer, and it was invented by George Papaniocolaou in 1928, eventually to be validated in 1940. However, even almost a century later, developing countries such as India are still debating the importance of the test while it has been made mandatory in developed nations decades ago. It is because of that that women in India often witness tumours of the size of 6-8 centimetres filling up their entire pelvis, if they ever get a pap smear done. Specially, women over 30 years of age are at a higher risk of getting cervical cancer.

So, what is a pap smear test?

It is a screening test for detecting cervical cancer, and involves a procedure of collecting or scraping out a few cells from the woman’s cervix (the lower end of the uterus, situated in the upper end of the vaginal cavity). But nothing to worry about as it is a simple, painless 5-minute outpatient procedure.

Regular screening can actually keep you safe from cervical cancer. Image courtesy: Shutterstock

A pap smear helps to detect cervical cancer it in its early stages, or to figure out any abnormal cells that suggest a possibility of developing a cancer in the future. It is carried on people who do not have any symptoms. Thus, it helps us to reduce the risk by lifestyle changes or early intervention in order to treat them effectively.

What is HPV testing?

Apart from a pap smear, hrHPV or High-risk Human papillomavirus DNA testing is also used in screening for cervical cancer since it is caused by the same virus.

While the virus has a lot of variants, out of them a few like 16 and 18 are found to be high risk varieties. The process of looking for the DNA of these viruses in the cells collected during the pap smear is called HPV testing. It is done in order to improve the accuracy of detecting precancerous conditions (possibility of developing cancer later). Hence, co-testing for cervical cancer, which means getting a pap smear cytology and hrHPV DNA test together, is suggested for any female who is above 30 years of age.

Also, read: Your quick guide to cervical cancer, because awareness is important!

How frequently should the test be done?

To know the screen frequency, let’s tell you:

  • No screening below the age of 21 years.
  • 21-30 years: Pap smear cytology once in 3 years.
  • 30-65 years: Pap smear cytology once in 3 years or pap smear- hrHPV cotesting once in 5 years or hrHPV test alone once in 5 years.
  • After hysterectomy (removal of uterus): If the surgically removed uterus does not show any cancerous or precancerous changes, no further screening is recommended.
  • After 65 years: If prior screening tests are normal, then it can be stopped. But if a person has never been screened before, it has to be done.
  • Exceptions: Pap smear cytology-hrHPV testing can be started from 25 years and be done once in 5 years.

What is the benefit of doing cervical screening tests?

Cervical cancer is the most common cause of cancer-related deaths in India, with more than 1 lakh (1,22,844) women being diagnosed with cervical cancer every year and more than 50 percent (67,477) die from the disease. India has the highest incidence in South Asia with a risk of 1 in 22 women developing cervical cancer. The ironic truth is that cervical cancer is the only cancer that can be screened, can be completely prevented, and effectively cured if detected early.

HPV vaccination is critical to protect against cervical cancer. Image courtesy: Shutterstock

Should you do a pap smear even if you are vaccinated?

Yes. HPV is a virus with endless variants. But we have developed vaccines for a limited number of known variants. Hence, the vaccine protects from most known variants causing cervical cancer but not for all possible variants. Hence, it is not 100 percent effective in preventing the disease. So, pap smear screening should be done even if vaccinated.

To say the least, cervical cancer is preventable. If caught early enough, it is fully treatable. A screening test is important before one develops obvious symptoms. It is strongly advised that women talk about it, be vaccinated at the age of 13, and begin screening at the age of 30.

About the Author
Dr Mathangi J

Dr Mathangi J, Senior Consultant and Department In-Charge, Radiation Oncology, BGS Gleneagles Global Hospital, Kengeri, Bengaluru

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