The Pap smear
- What is a Pap smear?
- What are the symptoms of cervical cancer?
- Who is at risk?
- What is the cause of cervical cancer?
- How effective is the Pap smear?
- How often should I have a Pap smear?
- Menopause - do I still need a Pap smear?
- Hysterectomy - should I still have a Pap smear?
- Should women with disabilities have Pap smears?
- When should I stop having Pap smears?
- How much does it cost?
- Where can I go to have a Pap smear?
What is a Pap smear?
In 1928, Dr Papanicolaou discovered that cells in the cervix change in appearance before they become cancerous. The Pap smear, named after the doctor, is used to check changes in the cervix (the neck of the womb) at the top of the vagina. It is a screening tool to find early warning signs that cancer might develop in the future.The Pap smear is a simple procedure. Cells are collected from the cervix and placed (smeared) onto a slide. The slide is sent to a laboratory where the cells are tested for anything unusual. If abnormal changes are found at screening, further tests will be done to see if treatment is needed.
The Pap smear is not for diagnosing cancer, but rather, for finding early changes which might become cancer.
A Pap smear only takes a few minutes. No drugs or anaesthetics are required and it can be done by a general practitioner, nurse or women's health worker.
The Pap smear does not check for other problems in the reproductive system. It is not a check for sexually transmitted infections. Women who are worried that they may have a sexually transmitted infection should talk to their general practitioner about the tests and treatments available.
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What are the symptoms of cervical cancer?
In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap smear.If you have any abnormal vaginal bleeding (such as intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your general practitioner.
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Who is at risk?
The risk of developing cervical cancer increases with age. All women with a cervix who have ever had sex at some time in their life are at risk of cervical cancer. About half the new cases of cervical cancer diagnosed each year are in women over 50 years of age. Women in this age group are less likely than younger women to have regular Pap smears. More women over 50 years of age die from cervical cancer because their cancer is diagnosed later when treatment is more difficult.Top of Page
What is the cause of cervical cancer?
Human Papilloma Virus (HPV), a sexually transmitted infection which in most cases (80%) is cleared by the body’s immune system in 8-14 months. The presence of HPV may be detected by the Pap smear. Some women who have persistent infections may develop abnormalities of the cervix. This is why it is important to have a regular Pap smears.Top of Page
How effective is the Pap smear?
Regular Pap smears every two years can help prevent up to 90 per cent of the most common type of cervical cancer.Like all screening procedures, the Pap smear has limitations. Sometimes it will not detect early cell changes because the smear did not contain enough abnormal cells. Sometimes samples are difficult to interpret due to blood or mucus on the slide. If this occurs, the general practitioner or nurse may need to take another Pap smear.
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How often should I have a Pap smear?
All women over 18 who have ever had sex are advised to have a Pap smear every two years, even if they no longer have sex. If a woman starts sexual activity at a younger age, screening should start within two years of first sexual intercourse.As the most common type of cervical cancer usually takes up to 10 years to develop, there is little advantage in having a Pap smear more frequently than every two years.
Your general practitioner may recommend more frequent Pap smears if a previous smear showed significant cell changes or you experience problems, such as bleeding or pain after sex.
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I’ve been through menopause; do I still need to have a Pap smear?
Yes, the risk of getting cervical cancer increases with age so it is important to keep having Pap smears every two years, even after menopause.Top of Page
Should I have a Pap smear if I have had a hysterectomy?
If your hysterectomy was only partial, and your cervix was not removed, you will still need to have a Pap smear every two years. If you have had a total hysterectomy, that is, your uterus and cervix have been removed, you may still need to have a Pap smear. Check with your doctor to be absolutely sure.Top of Page
Should women with a disability have Pap smears?
Yes, all women with a cervix who have ever had sex are at risk of cervical cancer. One of the key objectives of the National Cervical Screening Program is that its services are accessible to all Australian women.In all States and Territories women have access to a free telephone helpline (13 15 56) for further information on cervical screening, including access issues. This ensures women with disabilities can be directed to a practitioner who is best able to meet their individual needs.
In several States and Territories, strategies have been put in place to address the needs of women with disabilities who wish to have a Pap smear, including:
- purchase of adjustable examination couches;
- development of resources specifically designed for women with physical (including visual and hearing) and/or intellectual disabilities;
- referral to Pap smear providers who can meet women’s special needs in terms of physical and intellectual disabilities.
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When should I stop having Pap smears?
If you are 70 years or over and have had two normal Pap smears in the last five years, you do not have to keep having Pap smears, unless you wish to do so. Women who are over 70 years who have never had a Pap smear, or those who request a Pap smear, can make an appointment to be screened.Top of Page
How much does it cost?
There are two costs involved in having a Pap smear - the general practitioner’s or general practice nurse’s consultation fee and the Pap smear pathology test. Many general practitioners, clinics, health centres and pathology providers (laboratories) ‘bulk bill’ which case there is no cost for the Pap smear or the consultation.If a fee is charged, the cost to you will be the difference between the Medicare rebate and the general practitioner’s and pathology provider (laboratory) fees. In some cases you may be asked to pay the full fee and then claim a rebate from Medicare.
Ask for information about the cost when you make an appointment.
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Where can I go to have a Pap smear?
To make an appointment to have a Pap smear, you can contact:- your general practitioner;
- a community or women’s health centre;
- a family planning or sexual health clinic;
- a women’s health nurse; or
- an Aboriginal Medical Service.
For further information contact your GP,
health centre or family planning clinic, or ring 13 15 56 (for the cost of a local call).
health centre or family planning clinic, or ring 13 15 56 (for the cost of a local call).
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For further information email Cancerscreening
For further information email Cancerscreening
Page currency, Latest update: 01 September, 2006