Many women have plates that are overfull, day in and day out. It’s easy to neglect one’s own care when there is so much else to attend to. Yet, preventative measures, like Pap smears, are crucial to protect women’s health, wellness, and longevity.
Dr. Molly Thompson, Family Medicine Physician and Associate Program Director of the WSU Family Medicine Residency Program at Pullman Regional Hospital, shares important information women need to know—specifically in regard to cervical cancer.
Pap Test: Screening for Cervical Cancer
One key preventative screening is the Pap smear test. This involves checking for abnormalities, such as precancerous cells, infection, or inflammation. Pap screenings also check for the human papilloma virus (HPV). “We do this because the vast majority of cervical cancers, about 95%, are due to changes caused by that virus—which most people will be infected with at some point in their lives,” states Dr. Thompson.
Current guidelines indicate women between age 21 and 65 get a Pap test every three years, if results are normal. When a person turns 30, they have the option to undergo screening every five years. Cervical cancer takes multiple years to develop in women who have healthy immune systems. So, the duration of time in between is sufficient to protect against cancer—as long as women are completely consistent in their checkups.
“It's important to get our Pap smears at regular intervals so we catch any changes early. We want to catch cancer in the stages before it becomes concerning for cancer. The sooner changes are found, the better the outcome,” notes Dr. Thompson.
What should I expect during a Pap smear?
A Pap test should not be painful, but it can be uncomfortable. Make sure to inquire with your primary care physician or OB/GYN about different speculum sizes. A smaller speculum can make the experience easier, if deemed appropriate.
It’s also recommended women avoid vaginal-based medicines and sexual intercourse one to two days before the test, as doing so provides the best sample. If a woman is in the midst of her full-flow menstrual cycle, it may be beneficial to reschedule to a later date, as it can obscure the cells during microscopic assessment; spotting or bleeding lightly is acceptable.
“Ultimately, the best thing a patient can do to prepare for a Pap smear is truly just try to be as relaxed as possible. The more relaxed, the less uncomfortable the speculum is, and thus the Pap smear is. But, I know it's easier said than done.”
What if my results are abnormal?
Should a result return as concerning, the next step is to investigate further. One approach is called a colposcopy—a quick, in-office procedure that looks at the cervix under a magnifying device. In some cases, a small tissue sample is taken from the cervix to further examine the “grade” of cancer potential. Dr. Thompson wants to clarify that not all irregular Pap tests are the same. “With low grades, we can just watch for a year and retest. It's the other ones that are higher grade or persistent that we may have to turn to something like colposcopy.”
An additional procedure called loop electrosurgical excision procedure (LEEP) is designed for women who wish to have a biologic child in the future. LEEP uses an electrical current to remove abnormal tissue. If a woman has high-grade changes and was not looking to have a continued pregnancy, it would be reasonable to explore other options, such as hysterectomy.
If you don't currently have a primary care physician or are looking to make a change, the Family Medicine Residency Center is accepting new patients. Call (509) 336-7720 or email familymedicineresidencycenter@pullmanregional.org to establish care today.
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