Pap smear

[Raymie]

Hello,

Last time I went for a pap smear and STI check they put something actually inside my cervix. I don't mind things touching the outside, but inside is a bit much for me. Now I need another pap smear but I'm scared they will do it again. My questions are: do they have to put the swab inside my cervix? and can I tell them not to do that?

[Raymie]

Also; what if someone does leave it too late and the smear shows a false negative? How will the person know if they do have cancer?

[Heather]

Hey, Saffy, it's so good to see you.

A pap shouldn't involve anything inside the cervix: it's just about taking a sample from the os. It can feel, sometimes, like the swab is going inside, so I'm not sure if that's what happened here or not. Did you talk with them about this at the time?

I'm not sure what you mean by "leave it too late." Do you mean if someone waits many years to get pap smears?

[Raymie]

Hey! Great to see you too.

It was part of my STI check, and they warned me it would feel even weirder than the first time they touched my cervix where it was just a little brush against it. Maybe it just felt like it was going to go in, and freaked me out. I'm so squeamish, I'm sorry!

Yeah, say someone first had genital intercourse at 16 and then just never went for a pap smear until they were in their late twenties. If they did already have symptomless cervical cancer, would it be picked up?

[Heather]

Ah, so that was likely a swab (which is different than a smear, in exactly what those words mean in general) for your STI testing -- probably specifically a gonhorrea/chlamydia test. So yeah, when we get those tests, that's how they have to go. But a pap smear is pretty much just a brush-by of the os: it's less invasive.

And no need to be sorry! Everyone feels different about how they are touched, including in healthcare, and it's not like being comfortable with a kind of touch makes someone better than a person who isn't. You get to feel how to feel about this.

With the paps, you know, over the decades, they keep moving the time of life or age people should start them later and later, so at this point, with a pap specifically, I'd personally even be comfortable saying so long as people start getting them in their 20s sometime, they're probably good. And yep, the one you just got is no less reliable now than it would have been earlier. But that's certainly a concern you can voice when you have your pap if you want.

[Raymie]

Thank you so much! That's so reassuring about the age for paps being moved later and later. And yep, it was the chlamydia / gonorrhea test. Thank goodness paps aren't like that!

So, a pap can pick up cancer if a person has it, even if the HPV virus is long gone? The HPV infection disappearing is so scary!

[Heather]

A pap isn't an HPV test: it's not looking for nor can it identify HPV. It's a swab too look for cervical cell changes that will happen with cervical cancer, usually due to HPV. Make sense?

[Raymie]

It does, thank you.

At least when I go for a new STI check up, I'll know what to expect now as well. It was probably just because I wasn't used to it. It will get easier over the years.