The statutory health insurances offer women various health check-ups as part of the annual gynecological cancer screening. These studies include the cervical smear.

What is the cervix?

A cervix is ​​a cell smear from the area of ​​the cervix. Using a cotton swab or spatula, cells are removed from the cervix.

A cervix is ​​a cell smear from the area of ​​the cervix. For the smear, the gynecologist introduces a speculum into the vagina to stretch it slightly so that the gynecologist has a better view of the cervix.

Cells are then removed from the cervix using a cotton swab or spatula. The gynecologist can usually detect abnormal tissue changes or possible pathogens under the microscope. Subsequently, the cell smear is sent to a specialized laboratory, where a so-called Pap test is performed to detect altered cells, precursors of cancer or cervical cancer early and to be able to treat them as needed.

Function, effect & goals

A cervical smear is one of the gynecological checkups to reduce the risk of female cervical cancer in women. Cervical cancer is one of the most common cancers in women.

The smear test is performed to diagnose and treat cervical cancer as early as possible, and to prevent the onset of the disease through early detection. The Pap test already detects cell changes and abnormalities. This test is carried out approximately since 1970 in Germany in the context of gynecological check-ups. These improvements in diagnostics, along with improvements in living and hygiene conditions, have resulted in a decreased cervical cancer rate.

The cervical smear is named after its discoverer Papanicolaou, a Greek physician, also Pap test. Not infrequently, abnormal changes are observed in this study, but they do not necessarily mean cancer. It can also be inflammation or slight cell changes that can regress again. If a precancerous lesion is detected by the Pap test, the conspicuous tissue can be removed in most cases to prevent an outbreak of the disease. It usually takes years before cervical cancer develops, and repeated annual smears allow the formation of new cells to be observed, so regular annual screening with cervical smear is the surest way to prevent it.

The evaluation of the cervical smear usually takes place according to the Munich nomenclature, which divides findings into five groups. If abnormalities or tumor cells are found, further diagnostic measures such as a tissue sample or scraping are performed. It is not uncommon for smears to reveal conspicuous cell findings, which in most cases are harmless and continue to be monitored. If there is suspicion of a tumor due to the cervical smear, a biopsy is usually performed in which a tissue sample is taken and sent to a laboratory.

Although cervical cancer can occur despite regular preventive care, it is considered to be the safest precautionary measure because abnormalities in cell findings already appear before symptoms of illness appear. A regular annual cancer screening is therefore recommended to all women and perceived by most. And if the cervical smear detects cervical cancer, the chances of a cure are usually better because the cancer is usually diagnosed at an early stage. In case of abnormal but not dramatic findings, the cervical smear is repeated after 3 months in order to assess any changes.

Risks, side effects & dangers

Even though cervical cancer can usually be detected at an early stage due to the cervical smear or premature intervention does not even lead to the onset of the disease, the test offers no absolute assurance.

There remains a residual risk that cell abnormalities can be overlooked and there is cancer despite regular provision. But since the disease develops over a long period of time and the smear is made annually, conspicuous findings are recognized in about 90% of the women examined. Another risk is that there may be conspicuous findings and associated anxiety, even if medically everything is fine. There are also findings that go back by themselves.

For mild or moderate changes, therefore, gynecologists usually tend to watch and wait and repeat the test at intervals of a few weeks, so as not to disturb the women. If the cell abnormalities still remain after several smears, further diagnostic measures must be taken.

Another drawback is that although the cervical smear allows for early detection of cervical cancer, it does not allow for cancer of the uterus or ovaries. Therefore, the cervical smear during preventive examinations is combined with a gynecological examination of the ovaries and usually an ultrasound examination of the uterus and ovaries. The trickiest thing about these cancers is that they usually only cause discomfort when the cancer is already advanced. If a woman has ever been diagnosed with cervix cancer and treated successfully, she still has to take regular preventive care.

To compensate for the disadvantages of the Pap test, an HPV test was developed. The main cause of cervical cancer is suspected human papilloma viruses, which can be detected by this new test in cervical cells. However, this test is not yet part of the statutory pension benefits and therefore can not replace a cervical smear.

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