Cervico-Vaginal Smear

Why do you have a Pap smear?

Cervico-vaginal smear (or cervical smear test) allows the screening of precancerous lesions (atypia ...) and cancerous lesions (carcinoma ...) located in the cervix.

It also gives the opportunity to search for the HPV virus (human papillomavirus), some types of which are contributing factors for cervical cancer.

At what frequency ? The first smear is recommended by the HAS (High Health Authority) from 25 years.
If no abnormality is found after two normal smears performed at one year intervals, the rhythm recommended by the HAS is a smear every three years, until 65 years.

The first smear is recommended at HAS, the High Health Authority, recommends a smear every three years (after two normal smears performed at 1 year interval) from 25 years and up to 65 years.

Is it necessary if the woman has been vaccinated against papillomavirus? Pap smear screening applies to all women, whether or not they are vaccinated against cervical cancer. Both vaccines available are effective against 70% of the HPV viruses involved in this cancer. Pap smear monitoring is therefore essential for vaccinated women.

How's it going ?

Cervico-vaginal smear consists of collecting superficial cells of the cervix at a specific area (junction area). They are then analyzed by a laboratory.

What needs to be done before? Generally, no preparation is necessary. If the woman is in the menopause, she may be asked to perform a local treatment (gynecological egg) with estrogen.

Where to do a gynecological smear? Collection can be done by a gynecologist, attending physician or midwife in a doctor's office, hospital or planning or family education center. If the woman has a prescription, she can go directly to some medical laboratory where an authorized person will perform the smear.

What does the practitioner do? The woman is installed in a gynecological position. The doctor introduces into the vagina a speculum, which allows to remove the walls and visualize the cervix. Then he takes cells with a spatula or a small brush. He spreads them out and fixes them on a slide or plunges them into a bottle containing a preservative liquid. The cells thus conserved are sent to the analysis laboratory.

How long does it last ? The exam is very fast. The sample itself only lasts a few seconds. The installation of the person and the setting up of the speculum require a few minutes (5-10 minutes).

Is it painful? Cervico-vaginal smear is usually painless. It can be unpleasant.

When are the results? Generally, the results are obtained in one week. They will be communicated either to the doctor-sampler only (who then transmits them to the woman concerned), to the doctor and to the person who has undergone the examination.

In the event of an abnormal smear, a complementary examination, colposcopy (examination of the cervix using a magnifying device) must be performed to confirm or not the presence of suspicious cells. Depending on the appearance of the mucosa, a tissue sample (biopsy) can also be performed.

Are there risks and contraindications?

There is virtually no risk to smear, since it can even be done during pregnancy. There may be small, minor bleeding within one day of the swab.

Certain conditions must be respected so that the smear is performed in the best conditions:

• outside the menstrual period or bleeding,
• at a distance from sexual intercourse (48 hours),
• apart from any local treatment and any infection.

If the removal was not performed at the area of the neck of the junction (which is unfortunately not visible to the naked eye), the examination must be repeated.

The free smear as part of an organized screening

Because 40% of women do not smear regularly, this examination is now 100% supported as part of a national screening program organized (publication of the decree on May 4, 2018 in the Official Journal). Women who have not had a cervix smear in the previous 3 years will be invited by mail to visit a doctor or midwife for a free examination.