What is a pap smear?
A pap smear is a relatively simple test which looks for abnormal cell changes in the cervix and as a result, can detect pre-cancerous cells, most commonly for cervical cancer. In the rare instance that pre-cancerous cells are detected, Dr Sharon Li can remove them before they develop into cervical cancer.
This potentially lifesaving test involves Dr Sharon Li taking a swab from your cervix to remove cells. These will then be placed into a slide and sent for testing at a laboratory.
About the National Cervical Screen Program
The National Cervical Screen Program in Australia has recently changed. Late in 2017 a Cervical Screening Test was introduced to replace the routine two yearly pap smear test. In place of two-yearly pap smears, patients are recommended to have a five-yearly cervical screening test. The changes to screening are predicted to increase the early detection of adenocarcinoma and squamous cell cervical cancers caused by oncogenic HPV (human papillomavirus).
The screening test will start at the age of 25 for women who are sexually active. This test is more effective and just as safe and reduces the incidence and mortality from cervical cancer from 24%-36% when compared against the two-yearly pap smears.
What is an abnormal pap smear?
An abnormal pap smear result means some cervical cells have changed, however this does not necessarily mean pre-cancerous cells were detected. In fact, there are a range of other conditions which may result in a pap smear abnormality, including:
Abnormal pap smear management
The most common way that Dr Sharon Li grades your pap smear result is into 2 common categories: low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL).
HPV and abnormal pap smears
HPV (wart virus infection) is often associated with abnormal smears. HPV is a virus, which can produce warts on the genitals — commonly on the vulval skin, vagina and cervix. HPV may also infect the skin but have no visible abnormality. Wart virus infection is usually sexually transmitted. The wart virus may have been acquired recently or many years ago. It may have been present in the skin long before it produced the changes seen in the abnormal smear.
Abnormal pap smear diagnosis (colpscopy)
The first investigation is a colposcopy. A colposcope is a magnifying instrument, which allows the doctor to examine the cervix. Having a colposcopy is similar to a pap smear. Dr Sharon Li may take a small piece of tissue (biopsy) for examination by a pathologist. The biopsy may produce a pinching sensation but is not usually painful and is best done when you are not having your periods. There is often bleeding from the biopsy site – which the doctor will stop. However, you may have some spotting for a few days afterwards. The whole examination takes 10-15 minutes and may be uncomfortable, but not painful.
After the diagnosis, what next?
After Dr Sharon Li has discussed the results of the colposcopy and biopsy with you, she will advise you of the treatment options. The type of treatment depends on:
- The abnormality seen at colposcopy
- The grading of the abnormality
- Your age
- Whether you want more children
- Any gynaecological problems you may have.
Is a follow-up necessary?
Yes! Once you have had an abnormal smear you should always have regular pap smears. The responsibility for having regular smear tests is up to you! Discuss how often this needs to be with Dr Sharon Li. Treatment usually cures the abnormality, however, in a few women abnormal cells occur again. Follow-up smears will detect a recurrence or treatment failure.
Pap smear abnormalities Brisbane
Dr Sharon Li offers a comprehensive service for women who have abnormal pap smear results at her private clinic in Brisbane. For more information about abnormal pap smears, HPV or to request an appointment, please contact us.