Pap Smear Test - Cervical Screening in HK
Pap smear test is a simple and fast cervical screening that takes only a few minutes. By putting the speculum into the woman’s vagina and taking some cell samples on the surface of the cervix, they are then sent to the laboratory for testing.
The role of Pap smear test
It is used for regular cervical screening, early detection of abnormalities, timely treatment, and prevention of cervical cancer.
Who need cervical cancer screening?
Cervical cancer screening is usually used for women who have no symptoms:
- Women between 25 and 64 years of age who have had sexual experience, regardless of their marital status, should receive regular cervical cancer screenings.
- Women 21-24 years old who have had sex, have risk factors for cervical cancer (multiple sexual partners, smoking, low immunity)
- Women 65 years of age or older who have had sex and have never been screened for cervical cancer should be screened even if they have been asexual or ligated for many years.
- Even if a woman has been vaccinated against HPV, she still needs regular cervical cancer screening because HPV vaccine does not prevent all types of HPV infection
When should do cervical cancer screening?
All women who have ever had sexual intercourse should receive regular cervical cancer screenings from the age of 25. If the result of the first cervical smear test is normal, you should have a second test 1 year later. If the result of the second inspection is also normal, you can receive an inspection every 3 years. If you experience any symptoms (such as abnormal vaginal bleeding), you should seek medical advice as soon as possible even if the latest test result is normal.
What you need to know before Pap smear?
Within 48 hours before the pap smear test, the following activities should be alerted to avoid washing away abnormal cells, including:
- Douche the vagina
- Use spermicides and
- vaginal plugs sexual intercourse
It should not be tested during menstruation. If abnormal vaginal secretion or inflammation occurs, the vaginal infection should be treated first, and then the cervical examination should be performed.
Pap Smear Test Cost & HPV Test Cost
What does the cervical pap smear test result mean?
Approximately 90% of the cervical smear results are "negative" (normal), which means that your cervix has no abnormal cells, but you still need to be screened regularly. A "positive" or "abnormal" result means that there are some changes in cervical cells, but it does not necessarily mean that you have cancer. Most abnormal cells are caused by infection with HPV virus. A small number of women may have precancerous cell lesions and need treatment to prevent cancer from forming.
For a detailed explanation of Pap smear test results, please refer to Department of Health>Woman Health>Cervical Screening.
1. Negative results
Details: No abnormal cells
Suggested action: receive regular inspections
2. Atypical Squamous cells, unknown significance (ASCUS)
Details: Border cell disease, mild in severity, most of which will heal automatically
Suggested action:
- re-inspection within 6 months, If the lesion persists or worsens, colposcopy is needed
- Get a high-risk HPV test as soon as possible, If the test result is positive, you need to arrange a colposcopy test immediately
3. Low-grade squamous intraepithelial lesion (LGSIL)
Details: Approximately 85% of mild lesions will subside within 2 years, and about 15% will worsen.
Suggested action: need to perform colposcopy or biopsy, there is a chance to need treatment
4. High-grade squamous intraepithelial lesion (HGSIL)
Details: Moderate or severe cell lesions, 1-2% will become aggressive cancers
Suggested action: need to undergo colposcopy or biopsy, and receive treatment. After successful treatment, regular pap smear tests are also required
5. Squamous cell carcinoma (SCC)
Details: Cells appear to have the characteristics of cervical cancer
Suggested action: Receive gynecological diagnosis and treatment as soon as possible
Follow-up of Pap smear and HPV DNA test results
Co-testing with Pap smear and HPV DNA test improves the sensitivity of cervical cancer risk assessment by detecting abnormal cervical cells and existence of HPV at the same time.
HPV DNA Testing Result | Cervical Cytology Result | Recommendations* |
|---|---|---|
| Negative | Negative | Indicates normal result and a 5-year screening interval for Co-testing is recommended |
| Positive | Negative | Refer for colposcopy or repeat Co-testing after a recommended period depending on the genotyping result |
| Negative | Positive | Refer for colposcopy, or repeat Co-testing after a recommended period depending on the severity of cervical abnormalities |
| Positive | Positive | Refer for colposcopy |
*According to The Hong Kong College of Obstetricians and Gynaecologists (HKCOG) guideline on Cervical Cancer Prevention and Screening in 2016
