We know and understand, ladies: a speculum looks like a torture device and the thought of a stranger examining your vagina is off-putting, to say the least. But if these are the main reasons why you have been delaying that Pap smear, you might need to think again.
After all, following the introduction of Pap smears in Singapore, the incidence rate of cervical cancer has decreased from 18 women per 100,000 per year in the period 1968-1972 to 6.9 women per 100,000 per year in the period 2009-2013, according to the Singapore Cancer Society. But that's still 6.9 women too many.
Here are three compelling reasons you and other women close to you should get a Pap smear done.
1. It is life saving
Did you know that cervical cancer is the tenth most common cancer among Singaporean women and is the eighth most common killer among cancers of women in our country?
What is cervical cancer?
The cervix is part of a woman's reproductive tract, and is located in the lower part of the womb. Dr. Cheryl Kam, a family physician with Complete Healthcare International, explains that cells from this area of the body undergo constant change with a woman's monthly cycle and, as a result, are prone to abnormal growths. Sometimes, these abnormal growths are diagnosed as cervical cancer.
What causes cervical cancer?
It has been found that chronic infection with a virus called Human Papillomavirus (HPV) leads to cervical cancer. HPV is found in most sexually active adults and is easily cleared by the immune system most of the time.
Dr. Kam explains that in some cases, though, the body does not clear this infection on its own, resulting in chronic infection. There are no symptoms for this infection, nor is there a treatment, but it is known to lead to higher risk of cervical cancer.
Other risk factors such as smoking can increase a woman's chances of cervical cancer. The Mayo Clinic adds that having many sexual partners, early sexual activity, other sexually transmitted diseases (STDs), and a weak immune system are also risk factors for cervical cancer.
There is a new test that can be done at the same time as a Pap smear, which will detect if you have a current HPV infection. If the pap smear is normal but there is a concurrent HPV infection, your doctor will arrange a more detailed camera test to look at the cervix.
On the other hand, if the HPV test is negative along with a normal Pap smear, you need not do a Pap smear for another five years. There is also a three-dose vaccine against the HPV virus that you could talk to your doctor about, says Dr Kam.
What is a Pap smear and how can it help?
A Pap smear is a "screening test to check for changes in the cervix which may indicate that it may go on to develop cancer," explains Dr. Kam. This test is done to identify pre-cancer cells―in other words, abnormal cells―before cancer develops.
The beauty of a Pap smear test is that it is a simple and reliable way of detecting cervical cancer early on, which makes it possible for the cancer to be successfully treated.
2. It doesn't hurt!
Have you been worried by how painful a Pap smear could be? It doesn't hurt, ladies, which makes it all the more crucial to get one done (other than the fact that it is a potential life-saver!).
Dr. Kam explains that the procedure can be done for you by your family doctor or gynaecologist. While it may be slightly uncomfortable, it should be a generally pain- and stress-free procedure.
How it is done
You'll be asked to lie on the examination couch with your knees drawn up and apart. An instrument called a vaginal speculum is inserted into the vagina to help open the vaginal walls slightly. This exposes the cervix, which is the lower end of the womb that extends into and can be seen via the vagina.
A brush is then used to harvest some cells from the cervix, which, Dr. Kam says, you most probably will not feel. After this, the speculum is removed, and the Pap smear is over.
Your doctor may proceed to do a pelvic examination by gently inserting two gloved fingers into your vagina while placing his or her other hand on your stomach to check on the size, shape, and consistency of the uterus, ovaries, and fallopian tubes.
The cell sample, meanwhile, is smeared onto a glass slide or put into a container and sent to the laboratory to be examined under a microscope for any abnormalities.
According to Dr. Kam, depending on the lab used by your doctor, it may take anywhere from two days to two weeks to get the results. If the Pap smear results are not in the clear, your doctor will advise you on what your tailored plan for action is.
3. It is not expensive
According to the Health Promotion Board initiative CervicalScreen Singapore (CSS), the usual cost of a Pap smear at polyclinics is about $40. However, under the CSS programme, a Pap smear is offered at the subsidised rates of $15 for Singaporeans and $22.50 for permanent residents.
All Singaporeans and permanent residents are eligible to participate in this programme. To view the participating polyclinics, please follow this link.
You may also visit Community Health Assist Scheme (CHAS) clinics under the Integrated Screening Programme for a Pap smear. The test costs $24, excluding GP consultation fees and GST.
Dr. Kam advises that you can also get a Pap smear done by your friendly family doctor, or your gynaecologist. Prices range from $50-100 for a simple smear test.
Who should get a Pap smear?
All women 25 to 69 years old who have ever had intercourse are advised to have a Pap smear done at least once every three years.
However, the HPB advises you to see your doctor immediately if you have any of the following symptoms:
- Vaginal bleeding after sexual intercourse
- Irregular bleeding between menstrual periods or after menopause
- Foul-smelling vaginal discharge
Points to keep in mind before you go for your Pap smear
According to the HPB:
- Schedule your appointment two weeks after the start of your menstrual period.
- Avoid sexual intercourse 48 hours before the test.
- Do not use spermicides, vaginal creams, lubricant jellies, vaginal medications, or tampons two days before the test.
- Wear a two piece outfit as you would need to undress from waist down.
- Try to relax during the test―if you are anxious you may tense up down there, making it hard for the doctor to insert the speculum.
Mums, we hope your fears about getting a Pap smear are now eased. Do schedule one without delay if you have never had one before; also encourage your loved ones to get one done, too. One simple test can help you live a healthy life. You have to agree that it is worth the minor squirm factor involved!
If you regularly schedule Pap smears, do leave your words of encouragement for others who might not do so by leaving a comment below.