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What is the Papanicolau Smear Test??

The Papanicolau smear test is a screening method aimed to detect any preneoplastic lesions in the cervix.

When do I need to do the Papanicolau smear test?

The Papanicolau smear test must be repeated annually in the first 3 years of sexual activity, after which it should be done every 3 years for the rest of the woman’s life.

How do I get ready for the Papanicolau smear test?

A 48-hour sexual abstinence is necessary before the Papanicolau smear test.
No pharmaceutical products should be used and no vaginal washes should be done in the 48 hours before the test.
Also, the test is not performed during the days of menstrual bleeding.

What does the Papanicolau smear test consist in?

The Papanicolau smear test consists in the collection and analysis of cells from the surface of the cervix and from inside the cervical canal.
The cells are sampled with the help of a speculum and a soft brush, while the patient is lying in gynaecological position.
After the procedure, a discharge with traces of blood is possible and normal.
The specimen cells are squirted on glass slides with the help of a special brush and fixed in place with a special preservative. The samples are processed further and analysed under the microscope in a controlled laboratory environment.

How long does it take for the results to come in?

The results and cytological interpretation of the Papanicolau smear test take about 5-7 days.
In case the test confirms the presence of HPV infection or cytological anomalies, the results will include recommendations for appropriate follow up.

HPV testing
HPV is a virus with preferential tropism for mucosal epithelia. It is sexually transmitted and directly involved in the neoplastic transformation of cervical cells.

Up to now, more than 99 strains of the HPV virus have been identified. They are classified according to their virulence and carcinogenic effect into:

HPV strains with high oncogenic risk
HPV strains with potential oncogenic risk: 16 and 18.
HPV strains with high oncogenic risk, the most aggressive of which are 16 and 18 (other high risk strains are 31, 33, 33, 34, 35, 39, 45, 51, 52, 56, 58,59, 66 and 68)
HPV strains with potential oncogenic risk (26, 30, 34 53, 66, 67, 69, 70 73, 82, 85 and 97)
HPV strains with low oncogenic risk (6, 11, 28, 32, 44, 43, 44, 54, 55, 57, 61, 62, 71, 72, 74, 81, 83, 84, 86, 87 and 89). – These strains play a role in genital condylomatosis.

The type of virus is established either during a Papanicolau smear test or after a positive result confirming the presence of the HPV virus in the patient’s cervix.
What do I do if my Papanicolau smear test result is positive?
The result of the Papanicolau smear test must be interpreted by the attending physician, who will advise on the most appropriate course of action depending on the specific pathological modifications seen on the cervical smear.
For instance, the doctor may prescribe medical treatment or recommend further investigations such as the virus typing, a liquid-based Papanicolau test, or a colposcopy.

Ana-Maria Crețu, junior doctor, Obstetrics-Gynaecology