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Changes may occur in the cells of the cervix. This is known as dysplasia and can be recognised on the Papanicolaou smear. It is believed these changes may be pre-malignant so that treatment at this stage could prevent the development of cancer.

Cancer-in-situ is also detected by the smear. This is cancer at its earliest when there is no spread into the deeper tissues.

Once a woman becomes sexually active, she should have this test. Yearly tests are recommended by some but, in most cases, a Pap smear every two years should be adequate. Repeat smears at more frequent intervals may be necessary in suspicious cases.

If the smear test is positive, it is necessary to do a biopsy. A cone of tissue is removed from the cervix and examined under the microscope. If the presence of cancer is proved, operation with removal of the womb is usual.

In younger women who have not completed their families and in whom the cancer is localised and not spreading deeper into the cervix, it may be possible, if the cone has completely removed the cancer, to leave the womb temporarily. The woman can have her children and later have a hysterectomy. Regular three-monthly Pap tests are done to watch for recurrence.

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Tags: General Health