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Do pap smears hurt?

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Question: I would like to go for a cervical cancer smear test but am too scared to do so because people have told me that it hurts. Somebody told me they insert a metal rod into the uterus and the thought of this just puts me off.  Is it true? What happens during the smear?

Answer: As a result of research that evaluated the optimal frequency for cervical screening, women are now invited for their first test at 25. They’re then invited every three years until the age of 49, and every five years from 50 to 64. From 65, only those who’ve had recent abnormal tests are offered another test.

During a smear test, some cells are taken from the cervix. These are sent to a laboratory for examination under a microscope. To be able to judge the cells properly, this is best done in the middle of your menstrual cycle, halfway between one period and the next.

You will be asked to lie down on the examination couch, remove the clothing from the lower half of your body, and cover yourself with a sheet. The doctor or nurse will then ask you to get in the position that will best allow them to carry out the test. This will usually be lying on your back with your knees bent outwards and your ankles together, or with your feet in stirrups.

The doctor or nurse will insert an instrument called a speculum into the vagina to allow them to see the cervix. A spatula is then wiped or scraped over the surface of the cervix to remove some cells, which are then transferred to a glass slide. The doctor or nurse may also do an internal examination to check for any problems.

The procedure can be uncomfortable but shouldn’t be painful.  And any discomfort can be reduced by relaxing your muscles. Try to relax. Talk to the doctor or nurse if you’re worried.  The test is over before you know it, and if you’ve never had a pap smear before, you’re likely to find that the worry of having it done was much worse than the test itself!

The results

You should receive the result of your smear test in writing within six weeks. The result will be either normal (negative) or abnormal. A small proportion of tests can’t be completed because of a lack of visible cells on the slide. In such cases, you’ll be invited for a repeat test.

An abnormal test doesn’t necessarily mean cancer has been found or that it’s likely to develop. The laboratory has simply identified some changes in the cells that require further investigation.

In many cases, these are just minor abnormalities that would disappear without treatment. However, a few will progress to cancer, which is why further investigation is warranted.

Abnormal cells are scaled from borderline normal (‘not quite right’) through mildly abnormal, severely abnormal to invasive cancer. Depending upon the degree of abnormality, women may be asked to have a repeat smear in six or 12 months or referred for a further test of the cervix known as a colposcopy.–www.bbc.co.uk/health

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