Myths around health issues are not new, but I was particularly stunned when I heard “Pap smear” or “Pap test” (not Ogi, Akamu, or koko) was meant only for women with multiple sexual partners.
I was discussing with a friend recently about a pap smear and how I needed to stop procrastinating and get mine done. Her reaction and the comment that followed were shocking. She said she was surprised I wanted to do the test because I am married to one partner. In her words, “Isn’t the test meant for ‘promiscuous’ ladies? You don’t need it.”
How does being promiscuous relate to an important health check ladies are expected to do at intervals?
The thought that my learned friend had this view of pap smear suggested many women out there could be running with this same notion which can be detrimental.
People must have all the correct information to make important decisions about their health. This prompted us to verify this assertion.
What is a Pap smear?
Cervical cancer starts in the cervix and is discovered late in many women because it usually doesn’t cause symptoms until the late stages.
Almost all cervical cancer cases (99%) are linked to infection with high risk. Human Papillomaviruses (HPV) are a common virus transmitted through sexual contact.
When the symptoms of cervical cancer appear, they are easily mistaken for common conditions like menstrual periods and urinary tract infections (UTIs). The symptoms of cervical cancer include unusual bleeding between periods, after sex, or after, menopause-vaginal discharge that looks or smells different from usual pain in the pelvis, the need to urinate more often, and pain during urination.
Why get a Pap smear?
The Pap smear is an essential part of a female’s routine healthcare. According to the World Health Organisation (WHO), it is women’s fourth most common cancer. Aside from testing for precancerous or cancerous cells/changes on the cervix (the opening of the uterus), a Pap smear can also help find other conditions, like infections or inflammation.
Because it is usually done at the same time as a pelvic exam, it can test for certain types of HPV.
Who needs a Pap smear?
The American Cancer Society recommends cervical cancer screening should start at age 25, and people between the ages of 25 and 65 should get a primary HPV test every five years. If a primary HPV test is not available, a co-test that is an HPV test with a Pap test should be done between three to five years regularly.
Women who are HIV-positive or have a weakened immune system from chemotherapy or an organ transplant are at an increased risk for cancer or infection, so testing for these sets should be more frequent.
NOTE: It is important to still get regular Pap smears based on age, regardless of sexual activity status, because the HPV virus can be dormant for years and then suddenly become active.
How is a pap smear done?
Pap smears can be uncomfortable, but the test is quick. During a Pap smear, your doctor collects cells from the surface of the cervix and the area around it for screening.
This process involves using a small brush to gently remove them to be checked under a microscope for cervical cancer or cell changes that may lead to cervical cancer.
NOTE: Occurrences like menstruation, having sex a day before the test, and taking medicines like tetracycline can interfere with the test.
HPV and Cancer
The Centre for Disease Control (CDC) notes that all preteen girls need HPV vaccination between the age of nine to 26 years so they can be protected against HPV infections that can lead to cancer.
The CDC recommends that 11 to 12-year-olds receive two doses of HPV vaccine six to 12 months apart. The first dose is routinely recommended at ages 11 to 12 years old, but the vaccination can be started at age nine.
If the first dose was given before the 15th birthday, then only two doses are needed, but if children between the ages of nine and 14 received two doses of the HPV vaccine less than five months apart, they would need a third dose.
Teens and young adults who start the series later, at ages 15 through 26 years, also need three doses of the HPV vaccine. Vaccination is not recommended for everyone older than age 26 years.
NOTE: People vaccinated against HPV should still follow the pap smear screening recommendations for their age groups.
A gynaecologist at Garki Hospital Abuja, Sunday Idoko, explained that a pap smear is done for sexually active women. However, having multiple sexual partners increases the risk of cancer and HPV infection. He also added that this sexual activity is not limited to penetrative sex.
“Pap smear is a screening test for people with non-cancer and premalignant lesions of the cervix. It is done for sexually active women, usually from age 21 to 50 years. The results of the test will determine what happens. Women who do not have penetrative sex but engage in other forms of sexual intercourse such as oral sex or usage of dildos should also get the test done.”
Speaking on vaccination, he said both males and females from ages 9 to 21 should get vaccinated against HPV because cervical cancer, vagina cancer and vulva cancer have HPV as their common cause, which is transmitted via sexual intercourse.
A medical officer, Lynda Effiong-Agim, at the Chivar Specialist Hospital and Urology Centre, agreed with Dr Idoko and noted that the number of sexual partners is not a determinant of the type of women who can benefit from this test.
“Pap smear is recommended for all women 21 years and above who are sexually active (not limited to penetrative vaginal intercourse). The number of sexual partners does not determine the type of women to benefit from the screening test.
“As long as they are sexually active, they should have regular pap smears done on the average every three years,” she added.
While a Pap smear is recommended for sexually active women between the age of 21 and 50, our findings and experts reveal it is not only for women with transient sexual relationships.