Pap smear and pelvic exams are two integral parts of a typical well-woman visit, both of which are essential not only to maintain good reproductive and sexual health, but also to diagnose a medical condition or infection. Both are also conducted to detect gynaecological cancers.
Despite being usually done during the same appointment, a Pap smear and a pelvic exam are two different things.
What Is a Pap Smear?
A Pap smear or Pap test is a form of cervical cancer screening in Singapore that is done to detect abnormal (precancerous) or cancerous cells in the cervix. The procedure begins with the gynaecologist asking the patient to lie back with knees bent and feet placed on stirrups. The doctor will then gently insert a plastic or metal instrument called a speculum to widen the vaginal walls, allowing access to the vagina and cervix. A small spatula or soft brush is then used to scrape and collect a small sample of cervical cells. Once this is done, the speculum is removed, and the patient can sit back up. A Pap smear takes only 10 to 20 minutes to perform.
How Often Should You Have a Pap Smear?
It is highly encouraged by a cervical cancer doctor for women to have regular Pap smears from age 21 to 65. Gynaecological exams should be done annually, but in the case of a Pap smear, how often it should be done depends on the patient’s age.
If you are between 21 to 29 years old, and the result of your most recent Pap smear is normal, the doctor will advise you to do another Pap smear after 3 years.
If you are between 30 to 65 years old, you will also need to get a Pap smear every 3 years if the most recent one turns out normal. However, you are advised to undergo additional tests, including the human papillomavirus (HPV) test, which is done every 5 years. If both your Pap smear and HPV test come back normal, you can do the next round of test for both at the same time after 5 years.
If you are above 65 years old, you are no longer required to do screening.
What Is a Pelvic Exam?
A pelvic exam refers to the visual and physical examination of the woman’s reproductive organs, including the vulva, vagina, cervix, uterus, fallopian tubes, ovaries, bladder and rectum. It is done to check for infections and structural or functional problems with the reproductive system. A pelvic exam is typically done every year, or more often if the patient is pregnant.
What to Expect During a Pelvic Exam
Similar to a Pap smear, the patient will be asked to lie down on the exam table and place her feet up on stirrups, which rest on each side of the table. During the course of the examination, the following procedures will be conducted:
- External (visual) exam – visual examination of the vulva and vagina
- Manual exam – The gynaecologist will put on a lubricated glove and insert two fingers of one hand into the vagina, while the other hand is placed outside on the abdomen. This is done to check for any problems with the size, shape and location of the uterus, ovaries and fallopian tubes.
- Speculum exam – The doctor places a speculum to widen the vaginal walls, allowing visual inspection of the vagina and cervix.
- Pap smear – cervical cancer screening test
- Rectal exam – The doctor will insert a lubricated, gloved finger into the rectum to detect any palpable abnormalities or tumors.
A urine test may also be conducted to check for problems or infections affecting the urinary tract.
When Should You Have a Pelvic Exam
Women ages 21 to 65 years old can undergo a pelvic examination. An individual who underwent transition but has not yet done or not completed surgical assignment surgery is also allowed to do testing.
It is highly recommended to first identify your medical history, or assess for symptoms or problems before doing pelvic exams. Some doctors allow annual pelvic exams while others suggest doing the exam every three years until the age of 65.
Takeaway
Singapore has studies that show 309 women are diagnosed with cervical cancer with 172 dying from the disease. Cervical cancer is also the 11th most frequent cancer among women in Singapore between ages 15 to 44 years old.
Women should not hesitate to visit any cervical cancer clinics for annual exams especially if experiencing abnormalities for immediate treatment or doctor’s recommendation. Patients should also be educated on when to undergo Pap testing or a pelvic exam.
HPV vaccines are highly recommended in Singapore to protect women against cervical cancer.
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