When to do the papt test

" PAP test

Interpretation of results

The description of the results of the pap test has undergone numerous evolutions over the years, passing from the use of simple numerical scales (CIN1, CIN2, CIN3, then replaced by low and high grade SIL) to a descriptive system of the results. reason currently the interpretation of the examination is fully comprehensible only to a doctor who must be contacted in advance to understand the results of the examination.

The major limitation of the Pap Test is not so much the interpretation of the results as the danger that situations considered at risk may improve spontaneously. In other words, even if the result of the examination is not within the norm, any suspicious alterations can be excluded with investigations. and subsequent exams.

This aspect, which does not involve any physical risk for the woman, can however have very serious psychological repercussions. Let's think, for example, of the stress or useless apprehension that can generate the diagnosis of a risk situation in a young woman. We must also consider the hypothesis, supported by many psychologists, according to which the constant thinking about a problem could lead to the actual materialization of the problem itself.

The error or superficiality of the diagnosis is therefore a very serious problem, a psychological trauma with important consequences that every doctor should consider before generating unnecessary alarmism.

The papilloma virus (HPV) infection, as mentioned in the introductory part, can in fact regress spontaneously. This is a rather frequent phenomenon in young women, while, as the age advances, the probability that the infection is present increases. for a long time and is now in a chronic form, difficult to heal.

For this reason, the diagnosis of HPV infection is not necessarily related to an increased risk of developing cancer. However, it is a fundamental prerequisite for carrying out more frequent checks capable of monitoring the evolution of the infection. The persistence of the disease is in fact the only factor that can delay or prevent the spontaneous healing of the lesion. Vaccination campaigns are currently being carried out to protect women from HPV infections at increased oncogenic risk; however, it is important to emphasize that women who have been vaccinated against HPV MUST continue screening by PAP test.

Abnormal Pap smear: what to do?

In case of abnormal results, additional diagnostic or screening tests are usually done (such as the "HPV DNA test). In some cases it is recommended to repeat the Pap smear more frequently (for example every 12 months); in others the patient undergoes further diagnostic tests through colposcopy, a technique that allows you to directly observe the surface of the vagina and the neck of the uterus. Also in this case the recommendation to perform further tests does not necessarily indicate the presence of a malignant tumor, but rather the existence of a condition that needs a more accurate study.

The repetition of the pap test is also necessary in the presence of inflammation, procedural errors or failure by the patient to observe the rules of preparation for the examination.

Even if there are conflicting opinions in this regard, scholars usually attribute to the Pap test a diagnostic precision that is around 40-50% for the most skeptical and 80-90% for the most optimistic.

When to do the pap smear

The pap test must be performed away from menstruation, sexual intercourse and vaginal douching. In particular, the following rules should be observed:

The cytological sampling must be carried out in the period between the 3-5 days following the end of menstruation and the 3-5 days preceding the beginning of the menstrual flow.
At least two days of sexual abstinence must be observed before the examination
In the 3-5 days preceding the examination, the application of creams, pessaries and vaginal irrigators must be avoided
The pap test can also be performed during pregnancy without causing any problems to the fetus; gestation, in itself, is in no way correlated with an increase in the risk of developing cancer of the cervix, so the examination should only be carried out if there is a real reason
The pap smear should be followed for the first time at an early age, roughly between 21 and 25 years. International guidelines are now in agreement in advising against performing the examination as a screening method before the age of 21. In Italy, it is recommended to perform the first pap test at 25, and then repeat it every three years in case of negativity.
Virgin women can instead undergo the test without there being a lesion of the hymen; in these cases the gynecologist, who must be informed in advance, will adopt a more "delicate" technique without the aid of the retractor. The results of the examination. , given the difficulty in collecting cellular residues, they will however be less accurate. However, it should be remembered that the risk of cervical cancer in a woman who has never had sexual intercourse is very low so many screening programs exclude virgin women.
The pap test should also be repeated after menopause, at least until the age of 65-70, as it can also provide useful information on the state of the uterine endometrium.
In the absence of particular predispositions or risk factors (promiscuous sexual intercourse, smoking, AIDS ...), after the age of 21-25 the examination should be repeated once every 3 years; after the age of 30/35 it can be replaced by the " HPV DNA test, repeated once every 5 years in case of negative results.
In the event of abnormal results, the gynecologist may recommend the execution of other tests (colposcopy) or the repetition of the examination after a short period of time.

Even if you've never done it, it's never too late to get a Pap smear. As we have seen in this article, it is a simple exam that can really save many lives. On the other hand, it is good not to panic in the presence of unexpected results, both because in many cases they are harmless injuries and because in the case of early diagnosis the chances of recovery are high.