In Sri Lanka, we currently use a pap smear test to detect pre-cancerous lesions.

• You will be asked to undress from the waist down (removing your underwear as well) and a sheet will be put over you. 

• The doctor will then ask you to bend your knees, bringing your heels towards your bottom and then spread your knees apart. 

• The doctor will first look outside your vagina (the vulva) for any abnormalities. 

• They will then gently insert a smooth, tube-shaped metal tool (the speculum) into the vagina in order to visualize your cervix (this only takes a minute or so). 

• Once the cervix is visualized, a small sample of cells will be taken from your cervix using a small spatula.

• ​

The procedure is NOT PAINFUL, but you may experience mild discomfort. It takes only 5-10 minutes, but the doctor will conduct the procedure at your preferred pace.

Thereafter the doctor will gently insert 2 fingers into your vagina whilst pressing on your abdomen to feel for any abnormalities. 

Results take 3-4 weeks and you will be informed when ready.

How best to prepare for a pap smear

1. Do not have sexual intercourse 24 hours prior to your test date

2. Do not use vaginal creams, spermicides, lubricants or vaginal feminine washes/douching 2-3 days prior to your test date

3. It is best NOT to get a pap smear done during menstruation, when pregnant and if less than 12 weeks postpartum.

Testing Frequency

Currently in Sri Lanka screening is only at the age of 35 and 45 years. However, with the rising incidence of cervical cancers, women can be offered cervical smear screening 3 to 5 years since their first sexual intercourse. 

What else can be done?

Encourage all school going girls (10 to 11-year-olds) in Sri Lanka to take the HPV vaccine when offered by the MOH clinics in the government sector. Older females can access the HPV vaccine in the private sector. 

References

1. National Guideline on Early Detection and Referral pathways of common cancers in Sri Lanka for Primary Care Physicians (2020) National Cancer Control Programme, Ministry of Health & Indigenous Medical Services, Sri Lanka.

2. Kandanearachchi P et al. Guidance for cervical screening and management in Sri Lankan health care system. Sri Lanka Journal of Obstetrics and Gynaecology 2021; 43: 245-258.