Pap smears: your questions answered

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Pap smears are no fun but they're a vital part of every woman's health program

Some things are certain: the traffic lane next to yours will move faster, cats in hats are hilarious and here’s the kicker – no woman enjoys a pap test. They’re awkward, uncomfortable and generally, crap. But we know they’re essential to our health.

The Australian Cervical Cancer Foundation says 90 per cent of women who die from the disease had not had their pap test every two years as recommended. To better prepare you for yours, we hit up Dr Siobhan Bourke, a physician at the Victorian Cytology Service, to answers all your burning (sorry) questions. Now that, we like.

Q/ What’s a pap smear actually testing for?

“It’s looking at the cells on the surface of the cervix to see if there are any abnormalities. If left untreated for many years, they could proceed to cervical cancer.”

Q/ Is it also testing for human papillomavirus (HPV)?

“You can’t actually see HPV (the virus) with a normal microscope, which is what the pathologists are looking through. What they’re looking for are the changes that indicate someone has HPV. When someone has a low or a high-grade change on a pap test it’s showing some of the things the HPV virus may be doing in the cells. When any high-grade abnormalities show up on a pap test, you always go on to have a confirmatory test – a biopsy that’s taken to confirm the diagnosis.”

Q/ How can I take the ouch out of my next pap test?

“One way is to have a pelvic tilt. To achieve this, place a pillow, your hands or a rolled-up towel underneath your pelvis. When your pelvis is tilted up, your pelvic floor muscles are relaxed – and that’s the number-one thing that will make a pap smear more comfortable. The other thing is to breathe deep. I know it’s hard, but if you can keep breathing big, slow, deep breaths, it helps all the muscles down there stay relaxed.”

Q/ What is the best time during my cycle to get a test done?

“Within the first seven days after your period. At this time, a pap is usually much clearer to read as your progesterone levels are lower, so you shed more cells, which gives the pathologist more to test with.”

Q/ Is it normal to bleed after having my test?

“Yes, that’s completely normal. The instruments we use have a few bristles on them [ouch] and sometimes they can catch on the fleshier cells. Don’t worry if you get a little bit of spotting – it’s definitely not an indication that your cervix is abnormal.”

Q/ What’s the deal with ThinPrep?

“ThinPrep is the commercial name for a liquid-based method lab preparation of a pap test. The big difference between the ThinPrep test and the conventional one really is that ThinPrep increases the likelihood of being able to clearly read a smear. So in other words you’re less likely to have an ‘unsatisfactory reading’ and need a second test done. The difference is very small so in most cases a conventional smear is enough. [Note: Thinprep costs around $36]”

Q/ If I’ve had a clear pap test for several years and no new partners, can HPV just turn up?

“Yes, but it’s not just ‘turning up’, as if your body has just invented it. HPV can lay dormant in your body for a while. That’s why we keep doing pap tests all the way through until women are 70.”

Q/ If I have HPV, does that mean I will get cervical cancer?

“No, not everyone who gets HPV gets cervical cancer. In fact HPV is extremely common – around 90 per cent of men and women will have HPV in their lifetime. HPV is only a concern if your body’s immunity doesn’t naturally clear it. That’s the whole premise behind the Gardasil vaccine. If you can vaccinate someone against getting HPV then they’re much less likely to get cervical cancer. Regular pap tests on top of that is your safest bet.”

Q/ If my test is clear now, how likely is it that in the two-year interim, I could develop cancer?

“Very, very, unlikely. It’s even very unlikely that if you had a high-grade abnormality and then went back two

years later that you’d have cancer. If you have regular pap smears there’s usually always enough time for you to go off and see the gynaecologist and get treated.”

Q/ Aside from the HPV vaccine, is there anything else I can do to maintain a healthy cervix?

“The most important thing is genital skin hygiene. The vagina is a very good self-cleaning organ and it shouldn’t be tampered with too much. In fact, the less done, the better. Stick to using water to lightly clean down there and avoid using soaps.”

Come on down

A recent Newspoll survey found 97 per cent of Aussie women plan some type of “personal grooming” in preparation for their pap test:

28% organise some form of downstairs upkeep, whether it be a trim
or Brazilian
29% make sure they have a morning appointment with their doctor
32% plan their outfit for the day by wearing certain clothing (eg, a dress)
37% select specific underwear for the occasion

47% will wax, shave or laser their legs

For more information about pap tests head to Papscreen

Related: three must-have health tests