Updated Thursday, February 17, 2011
The Cervical Cancer Screening Program (CCSP) provides regular screening for cervical cancer to the women of British Columbia. The CCSP uses the Pap Test, an effective and widely used method to detect abnormal cells, so that physicians can initiate early treatment to stop cancer from developing. The Pap test may also detect infections and abnormalities in the endocervix and endometrium.
If you have any abnormal bleeding or spotting, contact your doctor or health care provider immediately, even if your most recent Pap test was normal
Frequently Asked Questions
What is a Pap Test?
A Pap Test is a routine screening procedure designed to find the earliest indications of cervical cancer. If caught early enough, the cure rate for cervical cancer and pre-cancer is very high.
The Pap Test involves the physician (usually a General Practitioner, during a routine patient examination) collecting cells from the cervix using a small spatula or brush. These cells are spread on a glass slide and sprayed with a preservative. The glass slide containing cells (also known as a Pap smear) is then forwarded to the Cervical Cancer Screening Laboratory (CCSL) for examination under a microscope. The physician receives the CCSL report and follows up with the patient.
Where is it done?
At doctor's offices and clinics. Pap tests are done by family physicians, obstetricians, gynecologists, nurse practitioners, registered nurses, midwives and naturopathic doctors.
How do I prepare?
- Plan to go for your Pap test when you're not having your period, if possible
- Avoid douching or using treatments, lubricants or foam inside your vagina for 48 hours before your appointment
- Remember any unusual signs, for example bleeding between periods or bleeding after sex, so you can tell your health care provider
- Write down your questions
How is it done?
Your doctor or nurse asks you to remove your clothing from the waist down and gives you a drape to cover yourself. Then he or she leaves the room. When the doctor or nurse returns, you are asked to lie on the examining table with your legs in stirrups and your bottom to the edge of the table.
To perform the procedure, your doctor or nurse inserts an instrument called a speculum into your vagina for a clear view of your cervix. She or he gently collects a sample of cells from your cervix using a small spatula or brush.
The test only takes a few minutes. It might feel a bit uncomfortable, but that’s likely because you’re tense. A Pap test is safe. You won't be injured. Try to relax, and remember – to protect yourself from cervical cancer you only need this test once every one or two years.
Where does the sample go?
The sample collected in your Pap test goes to the Cervical Cancer Screening Laboratory in Vancouver. A technologist examines your sample under a microscope to look for abnormal cells.
What happens to the slide when it gets to the Laboratory?
Laboratory employees immerse the glass slide in a special dye to stain the cells and make the cell structures more visible. (This special stain is named after the inventor, Papanicolaou, and became the basis for the name of the test.) Once stained, the slide is covered with a thin glass to preserve the cells and stain. Finally, specially trained medical technologists examine the slide under a microscope, looking for suspicious or abnormal cells. If abnormal cells are detected, a pathologist may be asked to further review the slide and report on the findings.
What about my result?
Within six to eight weeks of your Pap test, the Cervical Cancer Screening Program will send a report to your doctor or nurse. She or he will usually contact you only if abnormal cells were found.
Most women will have a normal result. In this case, continue with your regular screening. Abnormal Pap test results require follow-up.
Is cervical screening (the Pap test) reliable?
Cervical screening finds most cases of cervical cancer, but no screening test is perfect. Regular screening offers the best protection against cervical cancer.
To find out about new directions in cervical screening, read about the HPV Focal Study and the HPV vaccine.
How often should I get screened?
Once a year for the first three years. If these results are normal, then you can get tested every two years.
Screening may be stopped after age 69 if you have had no abnormal results. Women who have passed menopause or had their tubes tied should be screened.
If you’re not sure what to do, or you’ve had a total hysterectomy (surgery to remove the entire uterus with cervix), ask your doctor or health care provider what’s best for you.
Pap Smear Retention and Storage
What remains following the analysis?
The glass slide (Pap smear) prepared by the patient’s physician and reviewed by the laboratory is the final product of laboratory testing.
What happens to my Pap smear when the medical technologist or pathologist finishes the examination? Is the sample destroyed?
As with most medical records, Pap smears are stored off site for a defined interval and then destroyed. The secure storage facility has restricted access and a defined process to retrieve the sample if it is needed in the future for ongoing medical care.
Why does the laboratory retain my Pap smear instead of destroying it?
These slides are part of the patient’s medical history and record. They allow physicians to review historical patient results and determine if a detected abnormality represents a change in the patient’s condition. As a result, the slides are important for the ongoing management of a patient’s health. Re-tests or second opinions are common. It is not unusual to go back to earlier medical records to allow women and their caregivers to make the best health decisions long-term.
How long do you keep my Pap smear?
In North America, laboratories have legal and quality obligations to keep Pap smears for future reference and re-evaluation as women return for additional testing.
Hospitals and laboratories apply national standards and clinical best practice guidelines to determine the minimum intervals they must retain medical samples and records.
On a regular schedule, external accreditation organizations inspect facilities to confirm they are meeting all legal and quality requirements. Hospitals must pass these accreditation inspections in order to continue providing patient care.
The College of American Pathologists (CAP) is a major accreditation organization in North America. In their document “Retention of Laboratory Records and Materials” CAP publishes a 5 year minimum requirement for retention of cytology slides (slides containing cells). Hospitals usually apply more rigid criteria to meet clinical best practice guidelines.
To this end, the Cervical Cancer Screening Laboratory retains slides that do not demonstrate abnormal changes for seven (7) years. If abnormal cells are found, slides are kept for twenty (20) years. This ensures that caregivers have access to the slides if needed as they continue to care for the patient.
What happens to my Pap smear when the required retention interval is reached?
When the applicable retention requirements are met (7 years or 20 years), the Cervical Cancer Screening Laboratory sends written instructions to the storage facility with instructions to destroy specified samples.
Is the storage facility secure?
Patient privacy is a cornerstone of medical care in BC. The storage facility is extremely secure, with access limited to authorized personnel only. Only the Cervical Cancer Screening Laboratory can retrieve the slide, and the laboratory must adhere to a strict protocol with a written request. Both the storage facility and laboratory maintain written logs recording who requested the slide retrieval and when it was retrieved. Lab employees are trained to meet provincial medical privacy requirements.
Are Pap smears ever used for research purposes?
We store individual samples for the purpose for which they were collected, which is to support ongoing clinical management of individual patients.
Similarly, the laboratory does not extract DNA from the cells on the slide, nor use DNA in the screening process for cervical cancer. Results of the microscopic review are only recorded in the patient’s medical record and associated laboratory records required for diagnosis and care of the patient.
Is my Pap smear ever released to a 3rd party?
Pap smears are treated the same as hospital records or medical files. The only circumstance that a Pap smear could be released to a 3rd party is when the laboratory receives a duly executed court warrant. Laboratories are obligated to comply with court orders and release medical samples when specifically ordered to do so.
Can you analyze my Pap smear and then destroy the sample afterward?
This is not recommended for the reasons mentioned above. It is not unusual to revisit these slides during subsequent medical care. Destruction of the slide could place the long term health of a woman at risk as it could hamper ongoing management of any illness.
Can I pick up my Pap smear and take responsibility for its care and storage?
The current retention protocol is designed to ensure the Pap smears are stored appropriately for optimal survival and re-analysis as well as prompt retrieval by medical personnel. These are crucial benefits to the patient’s ongoing medical care. It is possible that the laboratory would be unable or unwilling to re-evaluate the sample at a future date if the storage conditions cannot be verified, thereby compromising the information available to the physician and patient for decision making.
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