By ADINA LAKSER
This October 16 to 20, the Federation of Medical Women of Canada will launch the 10th annual National Cervical Cancer Awareness campaign. Every year, the campaign emphasizes the importance of cervical screening, provides updated information and makes it as easy as possible for folks to get a Pap test. Many clinics even offer a drop in Pap test day to increase access.
Because guidelines have changed quite significantly in the past few years and, in general, there seems to be a lack of information about the who, what, where and why of Pap tests, here is a quick primer.
According to the Canadian Cancer Society, a Pap test, or Papanicolaou test, is a procedure that removes a small sample of cells from the cervix. Cells are looked at under a microscope to see if they are normal or abnormal.
And, yes, the Pap test is yet another thing all about a woman’s body that is named after a man. Dr Georgias Papanicolaou invented it in 1928. Another example is the G spot, named after gynaecologist Ernest Grafenberg. I highly doubt that women did not know about this pleasure zone until his “discovery” in the 1950s.
Anyways, back to the Pap test. During the test, the practitioner inserts a speculum inside the vagina to hold the walls aside and make viewing of the cervix possible. Then they use a small brush to collect cells from the cervix. The cells are sent for testing to see if any are abnormal. If the test comes back negative, all is well and the Pap is normal. If the test comes back positive, it’s an abnormal Pap. There are follow up tests, but it does not necessarily mean there is risk of cervical cancer.
Cervical cancer is usually slow growing, which is one of the reasons there is so much emphasis on early screening and detection. Routine cervical screening has been shown to greatly reduce both the number of new cervical cancers diagnosed each year and deaths from the disease.
Although going for a Pap test is rarely anyone’s favourite thing to do, it can and should be painless, respectful and relatively quick. I work with a group of women at the University of Manitoba who teach medical students, foreign trained doctors, nurse practitioners and basically anyone who will be wielding a speculum professionally, how to make the exam comfortable, both physically and emotionally, for the patient.
Some things you can ask for to make it more comfortable are a friend or family member join you in the exam room. Your legs should be covered by a drape (cloth or paper) at all times. You can have the head of the bed raised so you can see what’s going on. Let the practitioner know if you feel any pain or discomfort and they can make some adjustments. Since everyone’s body is different, there isn’t a one size fits all approach to speculum insertion, so if you feel any discomfort make sure to let the practitioner know.
A common misunderstanding about the Pap test is that it tests for everything, including sexually transmitted infections (STIs). Often the practitioner will do a chlamydia and gonorrhea (two of the most common STIs) test after doing a Pap, because once the speculum is in place it’s simple to do another test. But it’s not necessarily done automatically and it is a separate test from the Pap test. Other STI tests, such as for syphilis and HIV, are done through a blood test. As well, testing for gonorrhea and chlamydia can be done through a urine sample. Be sure to specify whether or not you’d like STI testing at the time of your Pap.
Another common misunderstanding is that you should have a Pap test done every year. While that may have once been the recommendation, now every three years is recommended for someone who has a history of normal Paps. So while it is a relief to not have to go so often, a downside is that women are getting fewer STI tests. Feel free to get tested for STIs even if you are not on schedule for a Pap.
It’s not only women who need to go for Pap tests. Anyone who has a cervix may also need to ensure there are no abnormalities. Trans folks are encouraged to talk to their medical practitioners or visit the trans clinic at Klinic to find out more about their cervical screening needs.
Hope this gives you some more information and encouragement to take care of your cervical health!
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