The Pap smear is a screening test for changes or precancerous lesions of the cervix. It goes back to the Greek physician Papanicolaou, who described the method.
Execution of PAP test
The PAP smear is usually performed during the gynecological examination. For this purpose, a few superficial cells are taken from the cervix with a fine brush, which are then examined by specialized cytological laboratories. The collection is largely painless, only a few women feel a slight irritation.
Significance of the PAP test
A cancer of the cervix is usually a very slow development but with serious consequences. Since this development does not cause any symptoms such as pain or bleeding, it is even more important to perform such a PAP test at regular intervals. With the examination and possibly the determination of HPV viruses, a risk with great significance can be made.
Frequency of PAP test
Between the age of 18 or after the beginning of sexual intercourse and 70, a PAP test should be performed at least every 3 years. If there is a slight change, checks may also be necessary at shorter intervals.
Cost coverage of the PAP test
A PAP test as a preventive examination must be paid for by the health insurance at least every 3 years, provided that the results were unremarkable. If the results of the PAP test are suspicious, checks at shorter intervals must also be paid for. Certain supplementary insurances also pay for the preventive smear test - PAP smear test - every year, as was generally the case in the past. Of course, you can also have a PAP test every year, but you will have to pay the costs of about 25 francs yourself.
Procedure of the PAP test
The PAP smear test is performed during a gynecological examination. This can be done for a variety of reasons, be it because of bleeding disorders, pain, infection or simply as part of a preventive examination. During the vaginal examination, a few superficial cells are taken from the cervix with a fine brush.
Result of PAP smear
You will receive the result of the Pap smear approximately 10 days after the examination. It is also determined when the next examination is recommended.
HPV and PAP test
Up to 90% of malignant changes in the cervix originate from HPV viruses. Of these, there are countless types, some are so-called high-risk variants, i.e. more dangerous for the development of cervical cancer. In addition to PAP test, it can be useful to determine these viruses, because a change in PAP test needs to be checked more or less frequently, depending on the presence of HPV viruses. The test is covered by health insurance if it is "indicated", for example, if the PAP result is suspicious or poor.
Since a few years there is a vaccination against certain common types of the HPV virus. It is recommended that this vaccination be given before the first sexual intercourse, if possible. The vaccination should also be done if the PAP smear is performed regularly. Up to the age of 25, the vaccination is covered by the state. Of course, the vaccination can be done later, it is still effective, but only for virus types that have not been picked up earlier. The cost of the vaccination is 3x 260 francs. Vaccination must be done after 2 and 6 months. The vaccination is harmless according to today's opinion and has already been used millions of times. The benefit of the vaccination has been clearly proven several times at the same time.
Assessment of the PAP smear
The assessment of the Pap smear is performed by cytological laboratories. The cells are evaluated according to a variety of criteria. At the end of the examination, the smear can be assessed according to one of the common classifications. The most common and well-known classification is the one according to Papanicolaou, which gave the name to the PAP test. A PAP I-II is considered a normal finding, a PAP III is a change which may correspond to a preliminary stage of a malignant change. A PAP IV - V corresponds to a malignant finding. Nowadays, in addition to the conventional PAP classification, there are more refined assessments which are used (often together with the HPV result) to determine the further procedure.
Consequences of a suspicious PAP smear test
Depending on the findings, a standard screening examination at least every 3 years, a check-up after 6-12 months or possibly further clarification by means of a biopsy is recommended. Mild to moderate changes can return to normal on their own, which is why control examinations via PAP smear are carried out at shorter intervals first. Severe changes may need to be confirmed by biopsy, which can be performed without anesthesia in the gynecologist's office, or treated directly by a ring biopsy in the hospital under anesthesia. Nowadays, such a ring biopsy or conization is usually performed with an electric snare on an outpatient basis. It is not dangerous and if done properly, pregnancy is possible without any problems afterwards. Following an operation, close-meshed PAP smears are always necessary in order to detect a possible recurrence at an early stage.