Your Pap smear and HPV tests are more necessary than ever

accreditation
A young woman excuses herself to make a call to her doctor
A young woman excuses herself to make a call to her doctor

Well, that’s the truth, but in South Africa, fewer than 20% of women have ever had a Pap smear. Yet, cervical cancer is the second most common cancer in South African women. 

To throw another spanner in the works: the Pap smear may not be fully reliable. Recently, news from Ireland revealed that over 200 women have been diagnosed with cervical cancer – after receiving false negatives on their Pap tests. This means, they were given the all-clear, yet still got sick. Eighteen have died. 

It could save your life 

We’re not going to sugarcoat it; a Pap smear isn’t the most glamorous thing in the world, and plenty of women skip it because it’s nerve-wracking and uncomfortable. An international study found that many young women, ashamed of their bodies, opt out of having a Pap smear. 

While body shame is real, are you willing to put your health at risk for fear of having your body examined by a doctor? “Please don’t let unhappiness or uncertainty about your body stop you from a life-saving test,” implores CEO of Jo’s Cervical Cancer Trust in the UK, funders of the study. 

READ MORE: Here are 12 things your medical practitioner wishes you knew about your sexual health

So, what does a smear actually do? We can thank Dr Georgios Papanikolaou all the way in the mid-1900s for his research, leading to the development of the test. The test collects cells from your cervix. These cells go to a lab to be examined for abnormalities; anything out of the ordinary that could signal cervical cancer. 

Pap smears are your burglar alarm system: early warning signs. The Human Papilloma Virus (HPV) is responsible for cervical cancer. Here’s the thing: you may have HPV and not even know it (which is why testing is essential). According to the Centers for Disease Control, cancer often takes years, even decades, to develop after a person gets HPV. 

The smear does not pick up cancer – it picks up the potential risk. So, there’s no reason to panic and assume that abnormalities automatically equal cancer. The other bright side is that while HPV infection is common; most infections are temporary and can be cleared by your immune system. 

Statistics show that for every one million women infected with HPV, only a small percentage develop cervical cancer. 

The tricky part

Your gynaecologist gave you the all-is-well call – but you got sick anyway. In some worrying cases, a Pap smear can fail. Reasons include: 

  • The lab misread the test results
  • Not enough cells were collected to give an accurate overview
  • You weren’t informed of the abnormalities

READ MORE: Not ready to have kids right now? Freezing your eggs could be an option

Cape Town gynaecologist, Dr Phillip Zinn explains, “A single Pap smear can miss an abnormality and an abnormality can occur between Pap smears. This may be due to a smear that doesn’t sample the area properly, or the person who is assessing it in the lab doesn’t recognise the abnormal cells. The detection rate of abnormal cells on a single Pap smear is as low as 60%, which is why the screening test must be repeated every few years.”

In addition, he says that severe abnormalities usually take years to develop, “So, this is fine as long as you have your smear every three to five years.” 

Thankfully, we have other options. Doctors may be relying more on HPV testing, which have shown promising accuracy. Studies show that HPV testing is more successful at detecting cervical cancer risks. According to the Washington Post, a study published in the Journal of the National Cancer Institute says, “HPV testing is more sensitive than the Pap test for detecting pre-cancer.” 

Dr Zinn is optimistic about this procedure. “A new development is the testing for the high risk types of Human Papilloma Virus (HPV) and this helps to decide how often a Pap smear is needed.”

The study found that the HPV test was able to pinpoint almost 60% more pre-cancer or abnormal cells than the Pap smear test; great news for us as early detection gives women more than a fighting chance of beating cancer. 

READ MORE: 7 signs of vaginal cancer every woman needs to look out for

Do not panic, go get tested 

False positives, abnormal results and other irregularities shouldn't stop you from having yourself checked regularly. From the age of 21, doctors recommend you have a Pap smear every three years. You can get tested at your gynaecologist, at the doctor’s office or a clinic or hospital. 

And what about the pain factor? As Dr Zinn explains, “A Pap smear shouldn’t be painful. The procedure requires an instrument to open the vagina to simply brush the surface of the cervix. When it’s gently done and you’re able to relax, it shouldn’t hurt at all. The instruments come in different sizes. A good tip is to tilt the pelvis up by sitting on your fists and relaxing all the muscles. This allows the cervix to come forward.” 

“Ideally all girls should be vaccinated against HPV before they become sexually active. It’s good to start having Pap smears from 25 years old if you’re sexually active.”

READ MORE: Ways to benefit from vaginal rejuvenation

Stub it out 

While cervical cancer can’t be traced to one outright cause or risk factor, credible research has shown an increase in the risk of cervical cancer amongst smokers – and your risk increases with the number of cigarettes you smoke a day. The earlier you start, the worse it gets. Stub it out, that cigarette does your health zero favours. “Anything that weakens a person’s immune system increases their risk, especially smoking and HIV,” says Dr Zinn. 

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