Pap smears important in detecting cervical cancer

August 16, 2011 

Why is it important to get Pap smears and when should you start getting one?

It is important for a woman to start getting Pap smears within three years of becoming sexually active because it can detect cervical cancer very early, when it is treatable.

Dr. George Papanicolaou is credited with having invented the Pap smear in the 1940s. It became widely used in the 1950s. Since then, the rate of cervical cancer has dropped more than 70 percent.

The majority of cervical cancers are caused by an infection of HPV (Human Papilloma Virus).

HPV is transmitted by skin-to-skin contact during sexual activity. Most people don’t even know that they have the virus when they give it to someone else.

There are many forms of the virus. Some of the viruses cause genital warts and some of them cause changes in the cells of the cervix. It is a very common virus. There are some estimates that as many as 20 million Americans are infected with HPV.

Pap smears are usually not painful. A swab of cervical tissue, the lower end of the uterus, removes cells.

The swab is then sent to a pathology laboratory where the cells are analyzed. News that your Pap smear is normal is always good news to receive. News that you have abnormal cells may mean that a more invasive test may need to be done or that you need to have more frequent Pap smears.

Your medical provider will give you the necessary guidance on what your next step should be.

The Pap smear is looking at cells where the exocervix meets the endocervix. This is called the “transformation” or “T” zone. It is where cells start to change from being squamous to glandular. The cells in the exocervix are primarily squamous. The endocervix primarily has glandular

or mucous producing cells. When the smear is done it is important that some glandular cells are on the sample. If the cells look normal it is called euplasia (the prefix eu indicates healthy or normal). If the cells are not normal it is called dysplasia (the prefix dys means bad or difficult.)

Around 80 to 90 percent of cervical cancer cell reports are classified as squamous cell carcinoma. This would indicate that the cells are from the beginning of “T” zone. If the report refers to the cells as adenocarcinoma that means the cancer cells are coming from the top of the “T” zone where the mucous cells populate.

This has become more common in the last 20 years. If the report says the cells are adenosquamous carcinoma that means there is a combination of both of the cells.

There are many types of HPV. Not all of them cause cervical cancer.

If you have ever had an abnormal Pap smear it is very important that you follow the advice of your medical provider. It may save your life.

Katie Powers, R.N., is a board-certified lactation consultant and perinatal educator at Manatee Memorial Hospital’s Family BirthPlace. Her column appears every other week in Health. Contact her at katie.powers@mmhhs.com.

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