Sometime it caught me by surprise when I asked patient about pap smear and they have no idea what it is for or never had it done before. Pap smear was developed by Dr Georgios Papanikolaou in the 1940s. If there was an award for the best husband of the year, it should be to Dr George who tirelessly took daily sample of cervical smear from his own wife to look at the changes occured in the cervix and in doing so revolutionised pap smear test, a widely available health screening test for women for detection of cervical cancer. What a dedication!
The introduction of pap smear has decrease the incidence rate and mortality associated with cervical cancer and has been one of the the most successful public health measures available for cancer prevention. Due to its slow progression rate, typically between 5 to 20 years, cervical cancer can now be detected and treated early.
Symptoms of cervical cancer includes abnormal vaginal bleeding (heavy flow menses, bleeding between the cycle, bleeding after intercourse), abnormal foul smelling vaginal discharge, painful intercourse and bleeding after menopause.
Sexually-transmitted high-risk Human Papillomavirus (HPV) infection causes more than 99% of cervical cancers. Cervical cancer is the third most common cancer among women worldwide. Risk factors importance for cervical cancer beside HPV infection includes smoking, immunosuppression, long term oral contraceptive usage, multiple sexual partners, onset of sexual intercourse at early age and history of sexually transmitted infection. Prevention efforts focused on education of safe sexual practice with use of condom as well as HPV vaccination such as Gardasil 9 for young girls and boys as early as 11 or 12 years old and up to 45 years.
The current recommendations by Malaysian Ministry of Health is pap smear screening for all women between the ages of 20 and 65 years old who are, or who have been, sexually active. If two consecutive yearly tests are negative, subsequent screening can be done every three years.
There are several reasons that militate against the participation of women in doing routine pap smear. Some of these include lack of awareness of benefits of screening for early detection of cancers, fear of pain, perceived high cost, lack of time and inconvenience visit to the clinic, embarrassment especially with male physician performing the test and perception of unlikelihood of getting a cancer diagnosis. Early detection by regular pap smear screening can detect early cancerous changes and prevent development of advanced cervical cancer.
If you have not done a recent pap smear screening and would like to know more information about cervical cancer and HPV vaccination, visit our clinic today for consultation