Cervical Cancer -The Cervical Smear Test

Cervical Cancer -The Cervical Smear Test

After the age of 20 years, women are invited by their GP to have a cervical smear test. The test is usually performed by the GP or practice nurse and involves visualization of the cervix with a speculum and sampling of the cells from the surface of the cervix - from the area around the cervical opening or os - this area is known as the transformation zone.
Cells on the surface of the cervix are collected on a wooden spatula and fixed onto a glass slide. The slides are subject to a staining process (by Papanicolau's method - hence the alternative name of Pap smear) in the laboratory and are then examined to detect the presence of pre-cancerous cells. Abnormal cells are termed dyskaryotic (meaning abnormal nucleus of the cell) and are graded as mild, moderate or severe, depending on the degree of abnormality present.

If the cells are normal then this is known as a negative smear. A positive smear is one where dyskaryotic cells are present. A high proportion of smears are neither negative nor positive. The sample may be unsatisfactory, or the cervical cells may be obscured by red or white blood cells, as may occur in the presence of infection. A smear may also be reported as borderline, which suggests minor cellular abnormalities, not amounting to dyskaryosis.

Negative smears are usually repeated every three to five years, unless there has been a recent abnormality. Positive smears are referred for colposcopy. Other grades of smear are usually repeated at three to six months.