Cervical cancer was the most common cancer and had highest mortality in women few decades back. Today the deaths due to cervical cancer has reduced by 70 to 80%. We attribute this to the success of screening by Pap smear. Today cervical cancer is theoretically preventable by regular Pap smears.

History of Pap smear 

In 1940s it was discovered that early pre malignant changes in cervix can be detected by making a smear of exfoliated cells of cervix and examining it under a microscope by a Greek physician named Georgis Papanicolau and his devoted wife Andromache Mavroyenous. This led to practice of Pap smear which is named after him.

Pap smear is a inexpensive and non invasive test in which the cells from cervix are collected using a wooden spatula and brush. A smear is made and fixed and studied under a microscope by a pathologist.

Who should undergo screening.
All women aged between 21 to 65 years should undergo Pap smear at least once in 3 years. More frequently when indicated. Precautions to be taken are:

• make an appointment excluding days of period
• avoid intercourse at least 3 days prior to Pap smear
• avoid douching or vaginal medications at least 2 days prior.

It’s known that the cells follow a defined pattern from pre malignant stages to development of cancer. The process is slow and predictable. There is a window period of 7 to 10 years from development of low grade changes to development of cancer. Hence Pap smears detect pre malignant changes early and give enough time to treat it.

If smear is abnormal further tests like colposcopy, cervical biopsy, HPV DNA testing is done. Low grade changes are treated conservatively, cryotherapy or laser. High grade changes are treated by laser, conisation, LEEP excision and hysterectomy. Hence effective treatment and follow up is done thereby preventing cancer.

It’s very important that all women undergo regular check up and Pap smears for timely detection of cervical cancer.