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The pap smear test: screening for cervical cancer

Last month, I  took a Pap Smear test. I had been due for it anyway but kept postponing. There was always an urgent errand to run that kept me away from the doctor’s visit.

The 3 C’s were harder to resist; Coffee, Cake and Chat with girlfriends. On some days, I blamed the unpredictable January weather. It rained in the mornings, or randomly in the afternoon. On other days, I used the old-fashioned anecdotal line; I have an early morning appointment.

Anyway, it was raining heavily on this Monday morning in January that the doctor was expecting me.  I called to cancel. On Tuesday morning, I had to drop the kids at school. I couldn’t make it in time for the 8 a.m appointment. On Wednesday morning, when I left the house at 7.30 a.m, the traffic jam had began at my door. Would I really make it? I took a turn. Thursday and Friday of the same week weren’t better days either.

Having a pap smear is more more than waking up in the morning and visiting the gynecologist for the much-needed wellness check. It is a nerve-wrecking moment, even for the boldest women. Inabidi ujiite ka-mkutano kwanza.

Dr Nelly Bosire, Consultant Obstetrician & Gynaecologist

Exactly a week later, I went for my wellness check. It included a pap smear, breast examination and a diabetes assessment test. All spread out in two days. (The fasting blood sugar test and the breast examination is a story for another day)

Let’s first take a walk on this Thursday morning when I finally had the pap smear test.

First, I was too nervous to have breakfast, so I left home early enough for my 9 a.m appointment. The were unusually clear for a working day and when I arrived at the doctor’s office, the lifts empty and they led me to the gynaecologist’s office, faster than I expected.

At the doctor’s reception, I informed the nurse that I had checked in for my wellness test. She took my personal details, my temperature, weight and blood pressure, all between small talk. (I can’t remember what we talked about. Maybe the locust invasion) .

My eyes were searching around the consultation room, looking for a comfort point where I could fixate my eyes during the pap smear. I have been around doctors and nurses for most of my life (My parents are health workers too) but it’s different when its me seeing the doctor.

I now understand why people take flowers to hospitals. The wall was plain grey save for an insect on the wall that was oblivious of its location. How idle that the only place the fly could find comfort was at the doctor’s office.

My anxiety aside, the pap spear test was done. The doctor calmed my nerves and this is one of the most important decisions I have made in 2020, taking charge of my health.

So, what happens during a pap smear test?

The doctor checks the cervix for any cells that are not normal.

Wait. First things first.

What is the cervix?

Dr Nelly Bosire, a consultant Gynaecologist & Obstetrician defines the cervix as the part that connects the vagina (birth canal) to the upper part of the uterus.

The cervix also provides an exit from the uterus for monthly menstrual blood flow or a baby during delivery. When cancer affects the cervix, it is known as cervical cancer.

Cervical Cancer awareness with Teal and white ribbon symbolic bow colour.

According to Dr Bosire, scheduling screening tests regularly can catch the early signs of this type of cancer, if any.  The Pap test (or Pap smear) looks for pre-cancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

What happens during a pap smear test?

The doctor uses a plastic instrument called a speculum, to widen the vagina. The doctor then proceeds to examine the vagina and the cervix and collects a few cells and mucus from the cervix and the area around it. These are sent to a laboratory and the results comes out a few days later.

A discussion with your doctor allays any fears of the pap smear test. Photo by National Cancer Institute on Unsplash

Dr Bosire shares some tips on the pap smear test and explains how a sample is collected for the cervical cancer screening.

  • Keep Calm. Yes, staying composed makes all the difference. It’s not painful, just a bit uncomfortable
  • Let your doctor know if you’re menstruating because it may affect your results.
  • Avoid sexual intercourse, douching, or using spermicidal products the day before the test.
  • Lie on the examination table on your back with knees up and ben
  • The doctor uses small metal or plastic instrument called a speculum to open the vagina. This makes it easier for the walls of the vagina and cervix to be seen clearly.
  • A small sample is obtained using a wooden scraper or a small cervical brush. It’s not painful, but it can be uncomfortable. It should be over in 4 seconds.
  • The sample is transferred and sent to the lab for close and careful examination under a microscope.

When is the best time to have the pap smear test? Dr Bosire says it is most ideal when the woman is not menstruating.

Photo by Jaunt and Joy on Unsplash

Getting the results

 The results of the pap smear should be out in about a fortnight but should include;

  • A description of the woman’s menstrual status
  • The medical history
  • Was the sample adequate?
  • The final diagnosis
  • The recommendation for a follow-up visit

A negative or normal test finding means that the cervix looks healthy. All the cells are of a healthy size and shape whereas a positive or abnormal test finding means that something unusual is in the sample. The test found abnormal cells of a different size and shape.

According to Dr Bosire, an abnormal Pap smear result does not always indicate cancer. “ This could be due to an infection of the cervix due to chlamydia or another underlying infection,” Dr Bosire says.

After a pap test, you can resume your normal activities right after having a Pap test.

What is cervical cancer?

Cervical Cancer is the leading cause of cancer related deaths in Kenya. It affects the opening of the womb in women. It is caused by the Human Papilloma Virus (HPV) and can develop after many years of being infected by the HPV virus. Sadly, it is does not show any symptoms until the cancer is at an advanced state. Did you know that 7 women die every day from cervical cancer?

The cervical cancer vaccine in Kenya

Kenya introduced the HPV vaccine into the Routine immunization schedule in November last year in all public health facilities and outreaches. The vaccine is given to 10-year-old as two 2-doses within a 6-month interval.

The symptoms of cervical cancer include;

  • Abnormal vaginal bleeding after sexual intercourse
  • Back, leg or pelvic pain;
  • Fatigue
  • Weight loss
  • Loss of appetite
  • Vaginal discomfort
  • Odurous discharge
  • Single swollen leg

It is important for women of reproductive age from 18 years to schedule a regular pap smear.

It is life-saving.

Get your pap-smear test today, or encourage your mum, sister, aunty or daughter to get checked.


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