What is cervical smear (pap smear) and why is it done?
Cervical smear, since the 1940s cervical cancer and precancerous conditions to detect It is a medical examination method used. Thanks to this method, the incidence of cervical cancer has decreased by 70%. In addition, this method is also helpful in investigating the causes of inflammation of the cervix and vagina. A woman with no abnormality in her cervical smear has a less than 1% chance of developing a significant disease (precancerous condition or cancer) of the cervix in the following year.
How to take a cervical smear sample?
The sample is taken during the examination by the obstetrician and gynecologist. (If the sample is known to be taken, the vagina should be washed before the examination.) ma cost is required). A wooden spatula, a stick with a cotton tip, or cervix using a small brush cells are taken from . Cells collected in this way are spread on a microscope slide and alcohol is poured over it.
The cells on the slide are stained with the Papanicolaou method and examined by a pathologist. pathologist, this “abnormal” between cells detects whether there are . At the end of the review, a report containing the terms determined by the American National Cancer Institute (Bethesda Terminology) in 1988 report is prepared.
What is cervical cancer?
Cancer is the uncontrolled growth of cells in a way that harms the person. There are a number of ways to stop this proliferation. However; When proliferation is noticed late, it becomes difficult to stop it. Cervical cancer is a cancer in which approximately 500 thousand women are diagnosed every year in the world. Most of these cancers occur in developing countries, including Turkey.
The fact that cervical cancer is rarely seen in developed countries is due to the widespread prevalence of cervical dissemination in these countries. In other words, in countries where women are regularly examined in this respect, cervical cancer can be caught and eliminated before it even occurs.
Cervical cancer does not cause distinctive symptoms. When the patient applies to the physician with complaints caused by this cancer; The opportunity for early diagnosis is also missed. In some of such patients, the cancer has spread to the surrounding organs and is difficult to treat.
Whereas, In a woman who does not have any complaints, an initial cervical cancer that will be detected during regular examination can be treated completely and definitively.
From whom and how often should cervical smears be taken?
that every sexually active woman over the age of 18 should be examined annually for gynecological diseases;
It is necessary to take a cervical smear sample every 2-3 years from women aged 30 and over.
If no abnormal cells are detected in the examinations performed 2-3 times in a row, this frequency can be reduced. However; Cervical smear should be done regularly every year in people who smoke, have had their first sexual intercourse under the age of 18, have relationships with more than one man, and are known to have additional risks of developing cancer.
On the other hand, it would be appropriate for even healthy and non-risky women to see an obstetrician and gynecologist once a year, since being examined at regular intervals will have benefits other than protection from cervical cancer.
Why should cervical smears be repeated at regular intervals?
Regularly repeated examinations ensure that the disease is caught as “early” as possible. Evaluation of smears in the same institution allows previous smears to be re-evaluated and comparatively if necessary. In this way, even the slightest deviations from the normal can be detected in a timely manner.
It is an undisputed fact that the most effective way to prevent cervical cancer is to examine cervical smears. Most of these cancers occur in women who have never had a cervical smear in their lifetime. This shows that if the cervical smears of the patients had been examined before, they would have been caught before reaching this stage. On the other hand, like all medical examinations, cervical smear has a margin of error and, although rarely, cervical cancer can be seen in women who have had a previous cervical smear examination.
There are 100 thousand-300 thousand cells in each cervical smear sample. The pathologist tries to identify a few that are abnormal among them. The condition that abnormal cells are not noticed even though they are present is called “false negativity”.
When there are very few abnormal cells in the smear, when the sample is not taken from the abnormal cells, when the cells cannot be evaluated as healthy because of very severe inflammation; False negativity may occur due to the removal of abnormal cells from the environment by the use of vaginal drugs or washing the vagina before sampling.
What to do when “abnormal cells” are seen?
The action to be taken depends on the degree of abnormality in the cells. In mild abnormalities, your doctor may recommend repeating the cervical smear in 3 or 6 months, or he may take a piece of tissue from the cervix and send it for pathology examination.
Before this piece is removed, the cervix can be examined under a magnifying glass. This method, called “colposcopy”, is painless. When abnormal cells are consistently seen in repeated cervical smears, your doctor may consider various ways of “removing”, “freezing” or “burning” the diseased part.
When necessary and appropriate, removal of the uterus is also a treatment that can be considered.
Are “abnormal cells” always a sign of cancer?
No! Abnormal cells can also be seen in some inflammatory conditions and in some diseases caused by viruses. Whether this type of abnormality is present is determined by the work of your doctor and pathologist.
Is this examination necessary in women who have had their womb removed?
Yeah! The cells lining the vagina are similar to those lining the cervix. If the uterus removal surgery was performed because there are abnormal cells in the cervix; Vaginal smears should also be done at regular intervals. In other cases, vaginal smears may be taken less frequently.