How often do you really need a smear test? And why? And does it have to be done by the gynecologist, or can it also be done by the doctor?
I am a mother of three children, and after my births, I am used to an annual check-up with the gynecologist. But what if you have not had children yet, are still young, and have had no / few different partners? Does the smear make sense? Yes!
The World Health Organization recommends having a cervical smear for women aged 30 and regularly afterward (frequency depends on the screening test used). Everyone, regardless of your lifestyle. Why? Mainly to prevent cervical cancer or detect it at the earliest possible stage. This is the second most common cancer in women! After all, hundreds of cervical cancer cases are diagnosed every year. An average of more than 150 often young women die. This cancer is caused by infection with the human papillomavirus (HPV). The Pap smear does not directly detect the virus or cancer: it looks for abnormal cells. Abnormal Pap smears do not indicate cervical cancer in most cases. This cancer is relatively rare and occurs in 10 per 100,000 women screened each year. Abnormal smears do not mean that you have cancer. Usually, further investigation shows that nothing is wrong. But it is worth it.
A Pap test every three to five years, followed by appropriate treatment, reduces the risk of dying from this terrible disease by up to 80%.
Are women sufficiently aware of this, but do women get themselves screened enough? The 2015 population survey showed that only 60% of all women in Belgium between 25 and 64 had a Pap test. This means that 40% of the women did not undergo screening. In urban areas with great cultural diversity, this is even 50%. Our own Isala questionnaire showed that 85% had had a smear test before. The Isala women are clearly aware of the necessity.
Of course, it is not so nice to have a smear taken with such a medical instrument. Most smears are done at the gynecologist, but that is not necessary. It is also possible with the doctor. And more and more accessible alternatives, such as HPV self-tests, are being developed. Hopefully, such tests can convince more women in the future. At present, these tests are not yet used in Belgium and are not reimbursed, and the guideline remains the smear. The Isala doctors Veronique Verhoeven and Gilbert Donders, for example, were already involved in research into this. These are very similar to the Isala swabs and focus on the HPV virus itself.
Can you also get tested too much? Yes, because a positive test (especially when the virus is only detected) does not mean that you will develop cancer. The body almost always clears up the HPV virus within 2 years, and only sometimes cancer develops. Therefore, a suspicious smear test can lead to a lot of unnecessary stress and other negative psychological consequences, such as unnecessary shame about this sexually transmitted virus. Because the virus is not only transmissible through sex or penetration. Infection can also occur through the skin (caresses) or through contaminated objects (towels). When contaminated mucous membranes come into contact with healthy mucous membranes (through vaginal, oral, or anal sexual intercourse). Doctors and websites such as those of our partner in Belgium, Sensoa, thus play a key role in good communication.