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Pap Smear

Pap smear is also known as papanicolaou test. It is a test where the cells are collected from the cervical surface and examined under microscope to look for the signs of abnormal and cancerous cells. Normally the cervical cells do not change into cancerous cells overnight. The normal cells will go through a series of changes over time before turning into cancerous cells. Pap smear is able to detect changes in the cells long before they become cancerous. The duration for the normal cells to change into cancerous cells is about 2 to 10 years. So, if the pap smear is done regularly every 1 to 3 years, it is possible to detect early cervical cancer or cells that will later develop into cervical cancer. The chance of curing early cancer is very high.

When should I start pap smear?

Women should have the pap smear soon after they have begun their sexual life or reached the age of 26, and continue on annually until they are 70 years of age. For those women who have had total hysterectomy (removal of both uterus and cervix) done, pap smear is not required, unless the surgery was done as a treatment for pre-cancer condition. Women who have had subtotal hysterectomy (removal of uterus and cervix is left behind) done, will still need regular pap smear.

What should I do before pap smear?

Pap smear is not performed during menses because the collection of the cells may not adequate and the menstruation blood will obscure the findings. It is advisable to have your Pap smear done between Day 7 to Day 10 of your menstrual cycle (first day of  your menses is considered as Day 1). You should avoid the followings before the test:

1. having sexual intercourse,


3. using tampon, and
4. using vaginal pessary or cream.

What is done during pap smear?

You will be asked to lie on the examination bed, with your knees and hip flexed.

A speculum (dark bill), 4 inches in length, is inserted into your vagina to hold the vagina apart.

Under direct vision, doctor will use a wooden spatula to collect a sample of cells from the cervix.

The sample of cells will be spread on the glass slide and fixed with alcohol. This is then sent to the lab to be examined by the pathologist.

You will feel uneasy if you are doing this for the first time, but the whole process is painless.

What other advantages of doing pap smear?

During the pap smear procedure, the doctor may detect polyps, infections, cervical erosion which can be treated.

When can I get my pap smear result?

You will get your result in about 1 week time. Most of the time,  the result will be normal. If your result is abnormal, our nurse will contact you and advise you to come for a repeat test or consultation. An abnormal smear does not necessary mean that  you have cervical cancer, it only means that you need further investigations.

Abnormal pap smear can be due to any of the followings:

Inflammation in the cervix, due to monilia, papillomavirus, trichomonas, herpes virus and bacteria infections.
Cervical dysplasia where the  cervical cells at the squamous calamus junction show abnormal changes which will later progress to cancer of cervix. when the cervical cells change to cancerous cells but do not cross the base line, it is called carcinoma in situ. The pap smear report will be labeled as Class I, II, III, IV and V. See the table below.

Who has higher risk of cervical cancer?

Women with human papillomavirus infections of the cervix have higher risks of cervical cancer and this is associated with those who have multiple sexual partners or their male partners have multiple partners. Cervical cancer also very common in women who smoke.

Where can I get my pap smear?

You can have your pap smear in a gynaecological clinic, maternity home and practitioner clinic.

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