Cervical Screening (PAP Test)
What is the PAP test?
Cervical screening is a test performed by a nurse practitioner or doctor that will show that the cells on her cervix are normal and healthy. If the cells on her cervix are abnormal, follow up and treatment can be done to prevent those cells from becoming cancerous. The decrease in the incidence of cervical cancer since the 1950’s has been largely attributed to cervical screening and the early detection of abnormal cells. Sometimes during the procedure another swab is taken to determine if the woman has either Chlamydia or Gonorrhea. These are two common sexually transmitted infections (STIs). Women can have one or both of these STIs and can feel normal and healthy – that’s why testing is so important! It is wise to ask your health care provider to test for STIs as this is not always done at the same time as the PAP test.
What causes cervical cancer?
A virus called, Human Papilloma Virus (HPV), causes cervical cancer. There are over 100 different types of HPV and they are passed through sexual activity. Some types of HPV cause genital warts and others types if left untreated cause cervical cancer. Since HPV is sexually transmitted, it is necessary to have a PAP test after you begin sexual activity. Sexual activity includes intercourse as well as digital or oral sexual activity involving the genital area with a partner of either gender. This new information has led to changes in the Cervical Screening and Follow up Guidelines. Visit the website www.cancercare.on.ca to view the guidelines.
Who should have a PAP test done?
PAP Tests should begin at age 21 for women who are or have ever been sexually active. Women who are not sexually active by age 21 should delay the PAP test until they are sexually active. If your test result is normal, PAP tests should occur every 3 years. Screening every 3 years is safe and effective. PAP tests may be discontinued at age 70 if there have been 3 or more normal PAP test results in the previous 10 years.
Where can I get a PAP test?
You can see your nurse practitioner or family doctor for this testing.
Maintaining physical and sexual health is important.
Sexually active women need to have regular PAP testing and a physical exam done by a family doctor or nurse practitioner. Men and women need to be “Breast Aware” in order to identify and treat breast cancer early. Men need to become comfortable with their testicles and learn how to do testicular self exams, to check for lumps which may lead to testicular cancer.
PAP and Pelvic Exam
Cervical cancer is the second most common cause of cancer among women, but if diagnosed and treated early, it is the most curable.
PAP tests should begin at age 21 for women who are or have ever been sexually active. Women who are not sexually active by age 21 should delay the PAP test until they are sexually active. If your test result is normal, PAP tests should occur every 3 years. Screening every 3 years is safe and effective. PAP tests may be discontinued at age 70 if there have been 3 or more normal PAP test results in the previous 10 years. When women become sexually active, they put themselves at risk for both pregnancy and sexually transmitted infections (STI’s). STI’s can range anywhere from chlamydia and gonorrhea to genital herpes and genital warts. Genital warts are caused by the Human Papillomavirus or HPV. HPV is passed from person to person sexually. Certain types of HPV have been shown to cause changes in the cervix that may lead to cervical cancer.
In addition to HPV, other risk factors which may lead to cervical cancer include:
- Not having a regular PAP test
- Becoming sexually active at a young age
- Having multiple sexual partners
Some women may develop cervical cancer having no risk factors at all.
What Happens During a PAP and Pelvic Exam?
A PAP test is an normal exam women regularly have. It’s nothing to fear. It is a normal part of being a woman and staying healthy. Some women may feel more comfortable having this done by a female physician or nurse practitioner. The Haldimand-Norfolk Health Unit has a female nurse practitioner on staff to help women feel more comfortable while having this procedure done.
During a PAP test, your physician or nurse practitioner will insert a speculum into your vagina. The speculum holds the walls of the vagina open to allow your health care provider to examine your vagina to be sure it is healthy. While the speculum is in place, a sample of cells from the cervix will be collected and sent to the lab to be examined for cervical cancer. A swab (long Q-tip) may be inserted into the vagina to test for Chlamydia and Gonorrhea. Your physician or nurse practitioner will also do an internal pelvic exam. During this exam, the health care provider will check your ovaries, fallopian tubes, and uterus to be sure all these structures are healthy. If you feel you are at risk for an STI, ask your doctor or nurse practitioner to test for STIs during your appointment.
Breast cancer is a complex disease that is linked to different risk factors. You can’t change some of the risk factors like being female, getting older, starting your period early, going into menopause late, having dense breasts, having a family history of breast cancer, frequent chest x-rays before age 30, or a mutation in the BRCA genes. However, there are other risk factors you can change. By living well, about 1 in 3 breast cancers could be prevented. Important things such as having a healthy body weight, eating a balanced diet rich in antioxidants, being physically active, avoiding or limiting alcohol, quitting smoking, limiting hormone use, and reducing exposure to chemicals can help reduce the risk of breast cancer, and make you feel great too!