The pap smear test is a screening test for well women. A sample of cells from the cervix is examined for abnormalities. Abnormalities on the sample may suggest that an area on the cervix is developing, or has developed, cancer. The cervix can then be examined more closely by another technique, and any area of cancer, or pre-cancerous change (called dysplasia) can be treated, and hopefully cured. The whole reason for doing the test is to find these early changes and treat them before the cancer develops or spreads (invasive cancer). Other abnormal findings might be reported by the pathologists who examine the smear tests, but the test is primarily for detecting dysplasia or cancer. Tests specifically for sexually transmitted and other diseases can be performed at the same time as a pap smear.

Cervical cancer is the sixth most common cancer in Australian women, with about 360 women dying each year from the disease. About 1,000 new cases are diagnosed yearly. It is most common in women aged sixty and over (who are, unfortunately, a group who seem reluctant to have smears), but is still a significant killer of younger women, in their twenties and thirties. Screening well women for evidence of pre-cancerous changes is an effective means of reducing the death rate from cervical cancer. Unfortunately, the method is at present under-utilised, with only about 50 per cent of women being regularly screened, and that means there are still too many women dying unnecessarily from a treatable cancer. Older women, and women from non-English-speaking backgrounds in particular are missing our.

New methods of detecting pre-cancerous change, using blood tests and others, arc being investigated, and may be available at some time in the future. It seems that these are unlikely to replace the smear test, but may be useful as additional methods.


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