Smear test

The main basis of cervical cancer prevention (but not of HPV infection) in women currently involves routine screening by way of the Pap-smear test (or Papanicolaou’s smear, named after a Greek Physician in the United States, 1883-1962). This test involves a routine examination of a sample of cervical cells, known as cytological screening, in order to detect abnormal cervical cells. Unfortunately, there are no such screening tests available for men. Thus, there is no way to determine whether a male has the virus unless genital warts develop and are detected by the naked eye.

Generally a woman is indicated by a medical professional to start having a regular Pap smear test every 2 years from age 21 to 29 years, or after 3 years from the onset of sexual intercourse up to the age of 29 years; then every 3 years for women aged over 30 years with a history of 3 negative (normal) tests. It is strongly advised that women get screened regardless of their sexual preferences or practices. A woman is generally indicated by a medical professional to stop having Pap smear tests between the age of 65 to 70 with three consecutive normal Pap smear tests, and no abnormal tests in the previous 10 years. An older woman who is sexually active with multiple partners may still be indicated to continue having routine screening. However, it is very important that a woman, before deciding to start or stop having regular Pap smear test, consults her family doctor or gynaecologist.

If cell abnormalities are detected after screening, these are investigated further with procedures such as a ‘colposcopy’, where a doctor visually examines the cervix, and a biopsy. Depending on the results of these investigations, treatment may be required, ranging from taking medications, to having a surgical procedure or chemotherapy.

The picture below show how a smear test is carried out.

 

 

 

 

 

Liquid-Based Cytology

Liquid based cytology (LBC) is a technique by which cervical samples are prepared for examination in the laboratory. The sample is collected similarly to the tradition smear but the device used brushes cells from the neck of the womb. The doctor or gynaecologist then breaks off the head of the brush, where the cells are found and places it into a small glass container with preservative fluid. At the laboratory the sample is treated so as to remove material that may obscure, such as mucus or pus, and then a random sample of the remaining cells is taken. A thin layer of the cells is deposited onto a slide. The slide is then examined under a microscope by a cytologist.

 

What are the advantages of using LBC?

·         the collection process is simplified for the doctor.

·         cellular preservation is improved

·         The rate of inadequacy in reduced

·         No cells are wasted

·         faster method for the laboratory to screen as well as to report

·         Useful tool for teaching since  Multiple slides can be produced, which also allows for double checking when in doubt

·         Offers a standardized result thereby improving the service offered to the patient.

To date, LBC has not been found to be more sensitive or accurate, however it is more cost-effective.