The statutory health insurance companies offer women various preventive examinations as part of the annual gynecological cancer screening. Among these examinations is the cervical smear test.
What is the cervical smear test?
A cervical smear is a smear of cells from the area of the cervix. Cells are collected from the cervix using a cotton swab or spatula. A cervical smear is a cell smear from the area of the cervix. For the smear, the gynecologist inserts a speculum into the vagina to stretch it slightly so that the gynecologist has a better view of the cervix. Cells are then taken from the cervix using a cotton swab or spatula. The gynecologist can usually identify any conspicuous tissue changes or possible pathogens under the microscope. The cell smear is then sent to a specialized laboratory, where a so-called Pap test is performed to detect altered cells, precancerous lesions or cervical cancer at an early stage and to be able to treat them if necessary.
Function, effect, and goals
A cervical smear test is one of the gynecologic screenings designed to reduce the risk of developing cervical cancer in women. Cervical cancer is one of the most common cancers in women. The Pap smear is performed in order to be able to diagnose and treat cervical cancer as early as possible, on the one hand, and to prevent the onset of the disease, on the other hand, precisely through early detection. The Pap test can already detect cell changes and abnormalities. This test has been performed in Germany as part of gynecological screening examinations since about 1970. These improvements in diagnostics, together with improvements in living and hygiene conditions, have led to a decrease in the rate of cervical cancer. The cervical smear test is also called the Pap test after its discoverer, Papanicolaou, a Greek physician. It is not uncommon for abnormal changes to be observed during this examination, but these do not necessarily mean cancer. They can also be inflammations or slight cell changes that can disappear again. If a precancerous lesion is detected by the Pap test, in most cases the abnormal tissue can be removed, thus preventing the onset of the disease. It usually takes years before cervical cancer develops, and repeated annual Pap smears can be used to monitor the formation of new cells, so regular annual screening with cervical smears is the safest preventive measure. The evaluation of the cervical smear is usually done according to the Munich Nomenclature, which divides findings into five groups. If abnormalities or tumor cells are found, further diagnostic measures such as a tissue sample or curettage are performed. It is not uncommon for smears to reveal abnormal cell findings, but in most cases these are harmless and continue to be monitored. If a tumor is suspected on the basis of the cervical smear, a biopsy is usually performed, in which a tissue sample is taken and sent to a laboratory. Even though cervical cancer can occur despite regular screening, it is considered the safest screening because abnormalities in cell findings appear before disease symptoms develop. Regular annual cancer screening is therefore recommended to all women, and most of them take advantage of it. And if cervical cancer is detected by the cervical smear test, the chances of cure are usually better because screening usually detects the cancer at an early stage. If the findings are abnormal but not dramatic, the cervical smear is repeated after 3 months to assess any changes.
Risks, side effects, and hazards
Even though cervical smear tests can usually detect cervical cancer at an early stage or prevent it from breaking out in the first place through early intervention, the test does not provide absolute certainty. There remains a residual risk that cell abnormalities may be overlooked and that cancer will develop despite regular screening. But since the disease develops over a long period of time and the smear test is performed annually, abnormal findings are detected in about 90% of the women examined.Another risk is that abnormal findings and associated anxiety can occur, even if everything is medically in order. There are also findings that go away on their own. In the case of mild or moderate changes, gynecologists therefore usually tend to observe and wait, and repeat the test several times at intervals of a few weeks so as not to alarm the women. If the cell abnormalities remain even after several smears, further diagnostic measures must be taken. Another disadvantage is that the cervical smear provides early detection of cervical cancer, but not cancer of the uterus or ovaries. Therefore, cervical smear is combined with gynecological examination of the ovaries and usually ultrasound examination of the uterus and ovaries during screening examinations. The insidious thing about these cancers is that they usually only cause symptoms when the cancer is already advanced. If a woman has already been diagnosed with cervical cancer and successfully treated, she must still continue to receive regular screening. To compensate for the disadvantages of the Pap test, an HPV test has been developed. Human papillomaviruses are suspected to be the main cause of cervical cancer, and this new test can detect them in cervical cells. However, this test is not yet part of the statutory screening services and therefore cannot yet replace a cervical smear test.
