1. Cervical Screening: Do I Really Need a Pap Test April 2010

2. Learning Objectives What is a Pap test? Who should have a Pap test? How often should women have Pap tests? How do I get ready? What happens after? Abnormal results

3. What is a Pap test? A test that checks for changes in the cells of the cervix It is done in your healthcare provider’s office and only takes a few minutes Note: the Pap test does not check for sexually transmitted infections such as Chlamydia or Gonorrhea

4. Female Reproductive System

5. What is a Pap test? Cytobrush Spatula

6. Pap tests After cells are collected from the cervix they are sent to the lab to be checked under a microscope If any cell changes are found, they should be followed-up closely If needed cell changes can be treated so that cancer does not develop

7. Should I have a Pap test? If you have ever been sexually active, you should have Pap tests regularly starting at age 21 (or 3 years after becoming sexually active, whichever is later) Women should have regular Pap tests until at least 70 years old If you have had a hysterectomy, talk to your healthcare provider

8. Should I still have a Pap test if…

9. How often should I have a Pap test? Unless your healthcare provider tells you differently: – Have a Pap test once a year for 3 years. If the results of all 3 tests are normal, you can begin having Pap tests once every 3 years – For most women 70 years and older, Pap tests can stop if your last 3 Pap tests, done within the past 10 years, were normal

10. Example

11. Between Pap tests See your healthcare provider if you have any of the following symptoms: – Bleeding between periods – Bleeding after sexual intercourse

12. Where can I go for a Pap test? Make an appointment with your healthcare provider If you need a family doctor or want to go to a women’s health clinic: – Call Health Link Alberta at 1-866-408-LINK (5465) – Visit www.informalberta.ca – Visit www.cpsa.ab.ca

13. How do I get ready for a Pap test? Try to make the appointment for a day when you will not have your period Don’t douche or use birth control creams or jellies 24 hours before the test Don’t have sexual intercourse 24 hours before the test

14. How do I get ready for a Pap test? Write down any questions you may want to ask Be prepared to talk about your medical history Think of any unusual signs you may have Know when your last period started

15. Are there any risks to Pap tests? A Pap test can miss abnormal cell changes. So it’s important to have Pap tests regularly Having abnormal results can be very stressful Pap tests can find changes that might go away on their own. Following-up on these changes may mean extra tests are needed

16. What do I do after the test? Ask your healthcare provider how you will get your Pap test result For most women the result will be normal, but an abnormal result is common

17. Abnormal results are very common About 1 in 18 Pap tests in Alberta is abnormal An abnormal result does not mean you have cancer Did you know?

18. What does an abnormal result mean? An abnormal result means that cells taken from your cervix look different from normal cells under a microscope All abnormal results should be followed-up closely as some women will need treatment

19. Cell Changes Normal Cells Mild cell changes Moderate/severe changes Cancer cells (low-grade changes) (high-grade changes)

20. What causes an abnormal result? There are different causes of an abnormal result: – Bacteria or yeast infections can cause cell changes that look abnormal. These changes can be treated and do not lead to cervical cancer – Most changes are caused by human papillomavirus (HPV) Most women who have an abnormal result DO NOT develop cervical cancer

21. What happens after an abnormal result? This depends on what type of abnormal test you have: Low-grade (minor) changes – Repeat Pap test in 6 to 12 months High-grade (moderate/severe) changes – Referral for colposcopy

22. Colposcopy The cervix is looked at closely with a powerful magnifying tool (colposcope) Very similar to a Pap test The colposcope does not cause any discomfort because it stays outside the vagina A tiny sample of tissue may be taken from the cervix (biopsy)

23. After colposcopy If low-grade abnormalities are found you will need to be followed-up closely: – Repeat Pap test in several months, OR – Another colposcopy procedure If high-grade abnormalities are found treatment may be recommended. Most often these abnormalities can be treated successfully so cancer does not develop

24. If needed, possible treatments may include Laser Surgery: a laser beam destroys abnormal cells LEEP: a wire loop that removes a piece of tissue using an electric current Cone Biopsy: a cone shaped wedge of tissue is removed

25. What happens after abnormal cells are removed? Women who have had low-grade abnormalities need to have Pap tests every year for 3 years. If all the results are normal they can begin having Pap tests every 3 years Women who have had high-grade abnormalities should keep having a Pap test every year for the rest of their lives

26. Remember Cervical cancer can be prevented The greatest risk for cervical cancer is not having a Pap test Abnormal Pap tests results are very common – If you have an abnormal result see your healthcare provider so you can be followed closely – Following-up abnormal Pap test results can almost always prevent cervical cancer from developing

27. Go for regular Pap tests! Women, as the givers of life have a responsibility to the Creator, themselves, their family and the community to maintain their physical, spiritual, emotional and mental well-being

28. Questions? For more information contact: Cancer Screening Programs Phone 1-866-727-3926 Webwww.screeningforlife.ca