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      The Smear Test
  Thomas Ind, Gynaecological Surgeon.   thomas ind
    Gynaecological Surgeon Royal Marsden and
St George’s Hospitals
51 Sloane Street, London SW1X 9SW
Tel: 020 7201 2666; Fax 020 7823 1499
  Sloane Street Gynaecology Clinic  
The Smear Test
The cervical smear test (PAP test) is designed to detect pre-cancerous changes in the cervix (neck of the womb). Pre-cancerous changes in the skin of the cervix are called CIN (Cervix; In the skin; New cells or Cervical Intra-epithelial Neoplasia). CIN (dysplasia or SIL) causes no symptoms. These changes are sometimes referred to as 'dysplasia' or 'SIL' (Squamous Intraepithelial Lesions). Women are not aware of CIN unless they have a smear test.

The importance of CIN
There is a potential for pre-cancerous changes (CIN, SIL, or dysplasia) to become cancer. It is also possible for CIN to resolve untreated. It is not possible to predict which woman's CIN will go away untreated and which woman's CIN will progress to cervix cancer.

It is not certain how long it takes and whar proportion of CIN develops into cancer. If preventive measures are not taken, cancer develops in up to 50 per cent of cases. This might take several years to happen.

Those who should have a smear test

Most women 25 years or older should have regular smear tests (Pap tests). Most women over 65 no longer need smear tests. You should consult your doctor for your specific screening needs.

How a smear test is performed
The smear test (Pap test) is done at the same time as a pelvic exam. A sample of cervix cells is taken with a small brush. The specimen is immersed in a liquid. This newer method of taking a semar test is called ‘Liquid Based Cytology’ and is a more robust method of taking a smear test compared to the old method. The laboratory specialist will then classify the smear test into one of a number of normal or abnormal categories.

A normal smear test (Pap test)
The woman is informed and recommended to have the smear test (Pap test) repeated in three or five years' dependant on her age.

A minor abnormality on the smear test (Pap test)
The woman is informed and advised to have a smear test (Pap test) in six months. If the smear test is classified as having CIN1 then
colposcopy is recommended.

A larger abnormality on the smear test (Pap test)
The woman will be informed and invited to attend a
colposcopy clinic for further investigation and treatment.
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