Find out what a cervical smear is all about – who should have cervical smears and why they are recommended.

 What is a cervical smear?

A cervical smear, also known as a pap smear, is a test which takes a smear of cells from your cervix – the opening to the womb or uterus at the top of the vagina. It is a screening test which looks for abnormal cells, which in turn could be a sign of cancer. The test results therefore will not tell you whether you have cancer, but will report on whether the cells that were collected look normal.

Who should have one?

Every woman who has ever had sexual intercourse should have a cervical smear done from the age of 20, every 3 years, until she reaches 70. This is still the case if that woman has ceased to be sexually active.

Ensure your daughters, sisters, mothers and friends know about cervical screening and who is eligible for it.

How often should women have cervical smears?

Most women will be advised to have a cervical smear taken every 3 years.

After your first cervical smear, or if you have had a gap of 5 years or more, you may be advised to have a repeat smear after one year.

Some women may be advised to have cervical screening more often, for example if they have ever had an abnormal result. Every 3 years is the minimum.

When should I have a smear taken?

Mid cycle is the best – book it for 2 weeks after your period starts.

Where can you have a cervical smear taken and who can take it for you?

Many doctors and nurses are trained to take cervical smears. They operate from local doctors’ surgeries, mobile clinics, community health centres, Maori health centres and maraes. If you prefer your smear to be taken by a woman, mention this when you make your appointment.

What does having a smear taken involve?

 The nurse or doctor will ask you to take off your undies, lie on the bed with your knees up and ask you to let them fall apart. The more you are able to relax your leg muscles, the less uncomfortable it will be, so really let them go heavy and relax onto the bed. The smear taker will gently part your labia (the lips that cover your vagina) and insert a speculum. This is a plastic or metal instrument which helps them to visualise your cervix and ensure the smear is taken correctly. It is the width of two fingers and will be covered with lubricant to make it easy to insert. The nurse or doctor will look at your cervix and will gently scrape some cells from the surface of your cervix, using a small brush or spatula. It feels strange, but does not hurt. Afterwards you will get dressed again and find out how you will obtain your results.

How much does a smear cost?

Some General Practices are funded to provide free smears for women who are overdue. Check with your practice. Other services provide free or affordable smears, performed by female smear takers. For more information on where to go, and costs, see: http://www.nsu.govt.nz/current-nsu-programmes/1158.aspx

What are the implications of an abnormal smear result?

The majority of women will have a normal cervical smear result.

Some women will have an abnormal result and will be recommended to have a repeat smear in a few months and for many of these women the repeat smear will be normal. This is because of ‘false positive’ results, whereby the test picked up a possible abnormality that did not exist.

There are also ‘false negatives’ where the result came back as normal (negative changes) but in fact there was an abnormality in the cells that was not detected. For this reason, women are recommended to repeat initial smears after one year and regular smears every 3 years. As cervical cancer is slow to develop the changes will be picked up on subsequent smears.

In addition to this, occasionally the test does not obtain enough cells to enable the laboratory to carry out the screening test. The cervical smear will then have to be repeated.

If you get an abnormal result take these factors into account and do not fear the worst if you are recalled to have your smear taken.

What is the next step after an abnormal smear result?

Depending upon the cell changes that have been detected, you may be advised to have a repeat smear after a few months, or you may be referred for a colposcopy.

This is usually done by a gynaecologist and involves a detailed look at your cervix, using a camera that is gently inserted into your vagina. A sample of tissue may also be taken, for further analysis – this is called a cone biopsy. It does not hurt, but there may be spotting of blood on your panties afterwards.

The doctor will inform you about how to obtain your results.

What are the risks of having cervical smears?

The procedure carries no physical risk, but there is the risk of a false negative or false positive smear.

What are the signs of cervical cancer?

Cervical screening can pick up abnormal cells, long before they develop into cancer. If you experience any of the following in between your regular smears, please get it checked out by your family doctor –

  • Bleeding between periods
  • Bleeding after sex
  • Bleeding after the menopause
  • Unusual vaginal discharge

Cervical cancer is highly preventable through cervical screening every 3 years.

In this fully revised edition, a naturopathic physician shows women how to use the latest in natural therapies to heal your body and promote good health. This essential illustrated natural health resource for all women shows how women can use nutrition, lifestyle and natural therapies to keep themselves fit and well.

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Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

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