Pap Smears: Everything You Need To Know About Your First Visit

The cervical cancer screening tests are essentially free in government hospitals and clinics.

Cover image via Saw Siow Feng/CodeBlue & News Medical

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Cervical cancer is the third most common cancer among women in Malaysia

An estimated 1,682 Malaysian women are diagnosed with cervical cancer every year.

However, cervical cancer is preventable and early stages are treatable.

According to the World Health Organization, virtually all cervical cancer cases (99%) are caused by a sexually transmitted virus called the human papillomavirus (HPV).

In other words, if you are not infected with HPV, there are less chances of you developing cervical cancer.

The normal cervix (far left) and different stages of cervical cancer.

Image via American Pregnancy Association

Prevention and early detection of HPV is crucial

The good news is, prevention of both HPV and cervical cancer comes in many forms – you may get the HPV vaccine, go for regular screening (Pap smear), and practise safe sex.

There are two screening tests that can detect early changes in the cervix:
- The Pap smear (or Pap test) that looks for abnormal cell changes.
- The HPV test looks for the virus that can cause cell changes. However, this is not routine.

The Ministry of Health (MOH) recommends all women between the ages of 20 and 65 years who are, or have been, sexually active to get a Pap smear at least once every three years.

Image via News Medical

How to prepare for a Pap smear

To make the Pap smear as accurate as possible, it is recommended that for two days before the test, you should avoid:
- Having sex
- Using tampons
- Douching
- Using vaginal creams, suppositories, medicines, vaginal deodorant sprays, or powders

Also, try not to schedule your test when you are having your period.

Image for illustration purposes only.

Image via Saw Siow Feng/CodeBlue

What happens during a Pap smear

It is a simple test that only requires a few minutes.

You will be asked to undress from the waist down and lie down on an examination bed behind closed curtains.

The doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and cervix, and use a swab to collect a few cells from the cervix.

The sample is then smeared on a glass slide and sent to a laboratory to be interpreted.

When you have the test done, you will be told how, where, and approximately when you will get the results. Government clinics may take up to three weeks, while private clinics may only take three days and results can be told over the phone.

Image illustrating a doctor holding a plastic speculum.

Image via Muy Salud

Important reminders:
- It is normal to feel embarrassed during your first appointment, but there's really no need to be. Your vagina and cervix are just parts of your body and it's important to ensure they are healthy.
- Pap smears may be a little uncomfortable, but they should never be painful. You may ask for a smaller speculum size.
- After the test, you may feel mild discomfort or cramping, but it should not last longer than a day.
- If you have never had sex, talk to your doctor to help you decide if you want to do screening.
- Even if you have not had any sexual activity for a long time, it is still important to go for screening as scheduled.

How often do you need a Pap smear?

Your first two Pap smears are done one year apart. If they are both normal and healthy, then you will only need to go for a Pap smears once every three years after that.

If you did HPV testing along with your Pap smear and both results were normal, you will only need to go for a Pap smear once every five years.

If you have an abnormal result, it means some cell changes were found on your cervix and does not mean you have cervical cancer. Talk with your doctor or nurse.

Where to get Pap smears and how much they cost

You can go to:
- Government hospitals and clinics
- Private hospitals and clinics
- National Population and Family Development Board (LPPKN) clinics
- Non-governmental organisations, such as the National Cancer Society of Malaysia.

Pap smears at MOH hospitals and clinics are essentially free (all outpatient treatments cost RM1). You can also get a Pap smear done at LPPKN clinics for RM20.

Pap smears at private hospitals and clinics cost between RM40 and RM80.

You can also consider getting the HPV vaccine to prevent cervical cancer:

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