Cervical Screening: Do I Really Need a Pap Test

1. Cervical Screening: Do I Really Need a Pap Test April 2010

2. Learning Objectives • What is a Pap test? • Who should have a Pap test? • How often should women have Pap tests? • How do I get ready? • What happens after? • Abnormal results

3. What is a Pap test? • A test that checks for changes in the cells of the cervix • It is done in your healthcare provider’s office and only takes a few minutes • Note: the Pap test does not check for sexually transmitted infections such as Chlamydia or Gonorrhea

4. Female Reproductive System

5. What is a Pap test? Cytobrush Spatula

6. Pap tests • After cells are collected from the cervix they are sent to the lab to be checked under a microscope • If any cell changes are found, they should be followed-up closely • If needed cell changes can be treated so that cancer does not develop

7. Should I have a Pap test? • If you have ever been sexually active, you should have Pap tests regularly starting at age 21 (or 3 years after becoming sexually active, whichever is later) • Women should have regular Pap tests until at least 70 years old • If you have had a hysterectomy, talk to your healthcare provider

8. Should I still have a Pap test if…

9. How often should I have a Pap test? • Unless your healthcare provider tells you differently: • Have a Pap test once a year for 3 years. If the results of all 3 tests are normal, you can begin having Pap tests once every 3 years • For most women 70 years and older, Pap tests can stop if your last 3 Pap tests, done within the past 10 years, were normal

10. Example

11. Between Pap tests • See your healthcare provider if you have any of the following symptoms: • Bleeding between periods • Bleeding after sexual intercourse

12. Where can I go for a Pap test? • Make an appointment with your healthcare provider • If you need a family doctor or want to go to a women’s health clinic: • Call Health Link Alberta at 1-866-408-LINK (5465) • Visit www.informalberta.ca • Visit www.cpsa.ab.ca

13. How do I get ready for a Pap test? • Try to make the appointment for a day when you will not have your period • Don’t douche or use birth control creams or jellies 24 hours before the test • Don’t have sexual intercourse 24 hours before the test

14. How do I get ready for a Pap test? • Write down any questions you may want to ask • Be prepared to talk about your medical history • Think of any unusual signs you may have • Know when your last period started

15. Are there any risks to Pap tests? • A Pap test can miss abnormal cell changes. So it’s important to have Pap tests regularly • Having abnormal results can be very stressful • Pap tests can find changes that might go away on their own. Following-up on these changes may mean extra tests are needed

16. What do I do after the test? • Ask your healthcare provider how you will get your Pap test result • For most women the result will be normal, but an abnormal result is common

17. Did you know? • Abnormal results are very common • About 1 in 18 Pap tests in Alberta is abnormal • An abnormal result does not mean you have cancer

18. What does an abnormal result mean? • An abnormal result means that cells taken from your cervix look different from normal cells under a microscope • All abnormal results should be followed-up closely as some women will need treatment

19. Cell Changes Normal Cells Mild cell changes Moderate/severe changes Cancer cells (low-grade changes) (high-grade changes)

20. What causes an abnormal result? • There are different causes of an abnormal result: • Bacteria or yeast infections can cause cell changes that look abnormal. These changes can be treated and do not lead to cervical cancer • Most changes are caused by human papillomavirus (HPV) • Most women who have an abnormal result DO NOT develop cervical cancer

21. What happens after an abnormal result? • This depends on what type of abnormal test you have: • Low-grade (minor) changes • Repeat Pap test in 6 to 12 months • High-grade (moderate/severe) changes • Referral for colposcopy

22. Colposcopy • The cervix is looked at closely with a powerful magnifying tool (colposcope) • Very similar to a Pap test • The colposcope does not cause any discomfort because it stays outside the vagina • A tiny sample of tissue may be taken from the cervix (biopsy)

23. After colposcopy • If low-grade abnormalities are found you will need to be followed-up closely: • Repeat Pap test in several months, OR • Another colposcopy procedure • If high-grade abnormalities are found treatment may be recommended. Most often these abnormalities can be treated successfully so cancer does not develop

24. If needed, possible treatments may include • Laser Surgery: a laser beam destroys abnormal cells • LEEP: a wire loop that removes a piece of tissue using an electric current • Cone Biopsy: a cone shaped wedge of tissue is removed

25. What happens after abnormal cells are removed? • Women who have had low-grade abnormalities need to have Pap tests every year for 3 years. If all the results are normal they can begin having Pap tests every 3 years • Women who have had high-grade abnormalities should keep having a Pap test every year for the rest of their lives

26. Remember • Cervical cancer can be prevented The greatest risk for cervical cancer is not having a Pap test • Abnormal Pap tests results are very common • If you have an abnormal result see your healthcare provider so you can be followed closely • Following-up abnormal Pap test results can almost always prevent cervical cancer from developing

27. Go for regular Pap tests! Women, as the givers of life have a responsibility to the Creator, themselves, their family and the community to maintain their physical, spiritual, emotional and mental well-being

28. For more information contact: Cancer Screening Programs Phone 1-866-727-3926 Web www.screeningforlife.ca Questions?