If you are between thirty and sixty years old, you will be called every five years to have a smear test. Fortunately, the result is usually good. But what if it is wrong? We provide answers to the most important questions.
What does PAP stand for?
Pap is an abbreviation of the name Papanicolaou, a Greek physician who created the classification of the results of smears. Some physicians work with another more precise classification: the Kopac result. If you get a Pap or Kopac result, always ask your physician what the result means in your case and what will happen next.
How many women get an abnormal result after a smear test?
About 75 percent of women will experience an abnormal result in their lifetime. and that is quite a lot. If you get such a result. it raises questions. Moreover, you will probably be quite shocked. Just because you are referred to a gynaecologist for further examination, while you usually have no complaints at all.
When should you worry?
Women are often afraid that they might have cervical cancer if their smear test is not good. In the Netherlands, approximately 3 women per 100,000 women die from cervical cancer: at approximately 0.003 percent, that is not much. We! cervical cancer is a very nasty disease. where there is a big chance that you will lose your uterus and ovaries, with all the consequences that entails. For example, you will enter menopause if your ovaries are removed. It is therefore not without reason that women are called upon every 5 years via the population screening to have a smear test. Cervical cancer is most common in women who do not participate in the population screening and therefore do not have regular check-ups. It is therefore advisable to have that smear test done. This increases the chance that you will be there in time if something is wrong.
What does a negative result mean?
An abnormal result can be a false alarm. The result of a smear is expressed in numbers. Pap 1 is a good, normal result. With Pap 2 to Pap 5, something could be wrong: from an innocent irritation or infection to restless cells, a pre-stage of cervical cancer, or cervical cancer after all. If you get an abnormal result, a gynaecologist will first examine what the tissue in your cervix looks like. The gynaecologist does this by carefully examining the cervix, and sometimes also by taking a biopsy. He or she then removes a small piece of tissue, the cells of which are examined under a microscope. You feel little to nothing from such a biopsy. In half of the women with a Pap result up to and including 3a, no pre-stage of cervical cancer is found in the tissue. Sometimes it turns out to be an irritation of the cervix, caused by a yeast infection or - if you also suffer from bleeding after sex - chlamydia. Both can be treated with a vaginal tablet or antibiotics. Usually you have to come back after 6 months for a new smear, to check whether your body has cleared the abnormal cells itself. If so, you can safely wait 5 years until you receive the next call for a smear. If not, the endoscopic examination will be repeated.
Can you make your body clear out abnormal cells itself?
Not really. The only thing you can do is to ensure good resistance. Eat healthy, don't smoke, drink alcohol in moderation and exercise sufficiently. A preliminary stage can be treated well.
If you have pre-cancer of the cervix, what next?
With a Pap 3b result, the chance that the gynaecologist will find a pre-stage of cervical cancer during examination increases. But the chance of cancer is still small. It only means that you are on time. A pre-stage is easy to treat. It takes 10 to 15 years before there is a 50 percent chance that the restless cells will develop into cervical cancer. To treat a pre-stage of cervical cancer, the tissue with the restless cells is 'peeled away' from the cervix under local anaesthesia. This procedure is done with a warm wire. takes 10 minutes and is called a lis excision. The tissue is then examined microscopically to rule out that there are more restless cells in the deeper layers. A cervix is approximately 4 centimetres long. The gynaecologist removes approximately 2 to 3 millimetres of tissue from it. After a lis excision, you can simply become pregnant. There is also a good chance that after the procedure you will only receive smears with a normal, i.e. Pap 1, result.
How is cervical cancer actually caused?
Cervical cancer is caused by an infection with the HPV virus. that you get through sexual contact. So you could say that sex causes cervical cancer. Condoms help prevent infection by 70 percent. About 80 to 90 percent of all people carry the HPV virus in one or more variants. Not all variants of the HPV virus are dangerous. Only a small number of them increase the risk of cervical cancer. In many! women, the virus is 'cleared' by the body itself. But some continue to carry it. Then it can lead to a pre-cancerous stage in 3 percent. Because the virus is transmitted through sex, women sometimes think that the HPV virus is an STD and wonder if their partner has cheated. Understandable. But unnecessary. The virus is not an STD. And because HPV infections are so common. Some doctors doubt whether the virus is really only transmitted through sex. In addition, not all women with an abnormal smear have the HPV virus in their blood.
Do girls who are vaccinated against the HPV virus never get cervical cancer?
There are more than 100 variants of the HPV virus, 12 of which can cause cancer. The HPV vaccination protects against 2 variants that together cause 70 percent of cervical cancer cases. Those who have been vaccinated have a much smaller chance of cervical cancer later in life. Since 2009, the government has offered girls aged 13 the opportunity to be vaccinated against these 2 types of the HPV virus. Because the vaccination programme started so recently, the precise figures on the decrease in cervical cancer cases are not yet known.
PAP results at a glance:
- PAP1: The smear is normal. After 5 years you will get a new smear.
- PAP2: A number of cells look slightly different than normal. The smear is repeated after six months. The result is often normal then.
- PAP3A: Slightly abnormal cells have been found. You will usually be referred to a gynecologist for further examination.
- PAP3B: The cells are slightly more abnormal than in Pap 3a. Again, you are usually referred to a gynaecologist and sometimes minor treatment is necessary.
- PAP4: The cells are more abnormal than in Pap 3. The chance of treatment is high, about 90 percent.
- PAP5: The cells are very abnormal, the result may indicate cervical cancer. but that is not necessary. An operation and further treatment is necessary in that case.
Treatments after abnormal PAP results
WHC Amsterdam is an independent treatment center in Amsterdam with a focus on women's care. We support, treat and help a large number of women in the Amsterdam region with complaints and problems in the field of women's care.
What can we do for you?
Women's Healthcare Center provides expert care and support for women. Our team of specialisten will do everything they can to help you get the right diagnosis and find the best treatment options.
