Transcript Document

Pap Tests
Last updated March 2012
Notes for the presenter:
•
Order resources 2 weeks in advance from CervixCheck (TellEveryWoman.ca, resources page).
Suggested resources include:
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Brochure: Pap Tests: What you need to know
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Brochure: Pap Tests: Understand your results/ Colposcopy: What to expect
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Multi-Lingual Bookmarks: Pap Tests help prevent cervical cancer.
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Pap Test Toolkit
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HPV Vaccine Resource
–
Posters: Tell her how much you care
•
Print these slides and insert into a flipchart. These can be purchased at places like Staples or
Grand & Toy (Showfile).
•
Locate Pap test access sites in your region by visiting TellEveryWoman.ca under “Where can I go
for a Pap test?” Share this information with your group. There are editable posters on
TellEveryWoman.ca where you can enter the information and print it out to post at your site.
•
Don’t feel you need to have ALL the answers. If women ask questions you can’t answer, send the
question to the Recruitment & Health Promotion Specialist at CervixCheck and then get back to
your group. It is better to have the correct response than to guess.
•
This presentation will be updated over time. Contact CervixCheck for any updates.
•
Each Healthy Baby group is different. Please adapt as needed.
Presenter notes:
Round
To introduce the topic, go around in a circle and ask
each woman to respond to one of the following
questions:
1. What comes to mind when you think of Pap tests
or cervical cancer screening?
2. Do you know anyone who has ever had a Pap
test?
3. Do you know anyone who has ever had an
abnormal Pap test result?
4. What is one question you have about Pap tests?
Round
Presenter notes:
The Cervix
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The cervix is the opening at the bottom of the uterus – the organ where a
baby/fetus grows when a woman is pregnant.
In some women, abnormal cells can begin to grow on the cervix.
Abnormal cells are caused by a very common virus called HPV.
Optional: Print out an extra copy of the cervix slide to pass around for
people to take a closer look at where the cervix is located.
Optional: For facilitators working with immigrant groups - Please mention
the following points when talking about the reproductive system:
– Not everyone’s genitals look the same.
– Some women may have been circumcised. It’s important to use this
term as it is the first language term used to describe the procedure.
– There are different ways of doing circumcision.
– It is good to see a doctor or nurse for a Pap test even if you feel well.
Pap tests help prevent cervical cancer.
– If you are worried about pain or if you have pain during the test, it is
important to tell the doctor or nurse.
The Cervix
Presenter notes:
Healthy Cervix
• This picture shows the cervix from the
nurse or doctor’s point of view.
• This is a picture of a healthy cervix.
• The cervix opening (called the “os”) dilates
to 10 cm when a woman gives birth.
• Optional: Create a circle that is 10 cm in
diameter. Laminate the circle and turn it
into a name tag hung from a lanyard.
Healthy Cervix
Speculum
Cervix
Os
Presenter notes:
HPV (Human Papillomavirus)
• Abnormal cells are caused by a very common virus called
Human Papillomavirus or HPV.
• ¾ people will have an HPV infection in their lifetime.
• HPV is spread through intimate skin-to-skin genital contact
and sexual intercourse.
• Anyone who has engaged in sexual activity – even once – has
a good chance of coming into contact with HPV.
• Men & women give and receive HPV without knowing.
• Condoms should not be relied upon to prevent HPV
transmission because there is skin outside of the condom
that touches during sexual contact.
HPV (Human Papillomavirus)
• Can cause abnormal
cervical cells
• Very common
• Spread through sexual
contact
• Only takes one partner
• Men and women give and
receive HPV
Presenter notes:
Abnormal Cells
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If abnormal cells caused by HPV are left untreated on the cervix,
they could grow and develop into cervical cancer.
•
You may have abnormal cells and have no symptoms, the only way
to know is to perform a Pap test on a regular basis.
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Most women diagnosed with cervical cancer have never had a Pap
test, or haven’t had one in the five years before their diagnosis.
•
Most cervical cancers can be prevented if women have regular Pap
tests with follow-up for abnormal changes.
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Cervical dysplasia is a clinical term for abnormal cervical cells.
Abnormal Cells
• No symptoms
• Treat early changes to
prevent cancer of the
cervix
• Most cervical cancers can
be prevented if women
have regular Pap tests with
follow-up for abnormal
changes
Presenter notes:
Pap Test
Use the Pap Test ToolKit from CervixCheck to demonstrate the Pap test.
Ask for a volunteer to hold the cervix and explain the following:
1.
The woman will be asked to undress from waist down & given a drape to place over her
legs.
2.
She will lay on examining table with feet in foot rests.
3.
The doctor or nurse will:
- insert speculum into vagina.
- insert spatula into the cervical os, turn, remove, smear cells onto a glass slide.
- insert cytobrush into cervix, turn, remove, smear cells onto slide.
- spray the slide with fixative to preserve cells.
- remove the speculum.
The Pap test should not hurt. If a woman experiences pain, she should tell the doctor or nurse.
NOTE: The Pap test does not check for Sexually Transmitted Infections (STIs) (e.g. Gonorrhea,
Chlamydia). It looks only for abnormal cervical cells. If a woman is concerned about a
possible STI she needs to ask for an STI test.
Pap Test
Presenter notes:
Pap Test Results
Pap test results come back as negative, abnormal, or unsatisfactory:
1.
2.
3.
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Negative – No abnormal cells found on the cervix. A woman will likely need another Pap test in two
years time, however, this depends on previous screening history. She should check with the doctor or
nurse. The woman will not receive a phone call from clinic.
Abnormal – Abnormal cells were found on the cervix. A woman will need another Pap test or a closer
examination using a special microscope called a colposcope. This result does not mean that a woman
has cancer. A woman should receive a phone call from the clinic to book an appointment for a
colposcopy or a repeat Pap test.
Unsatisfactory – Not enough cells were taken or there were other types of cells on the slide that
made it difficult to read the slide. A woman will receive a phone call from clinic and be asked to
return for another Pap test.
Refer to “Pap Tests: Understand your results” brochure for more detailed information. An abnormal
Pap test result does not necessarily mean a woman has cervical cancer. Most of the time, abnormal
changes will disappear on their own without any treatment. Most women who have abnormal Pap test
results and who have follow-up tests and/or treatment will never get cervical cancer.
CervixCheck will attempt to follow up with women directly if the doctor/nurse is unsuccessful in
contacting the woman.
Women can call the doctor or nurse who did the Pap test or call CervixCheck to request a copy of
their results in the mail.
Pap Test Results
Pap Test Results
What it means
What to do
Phone call from
doctor/nurse
Negative
No abnormal
cells found on
the cervix
Have a Pap test
every 2 years
(unless you have
an abnormal Pap
test result)
No
Abnormal
Abnormal cells
found on the
cervix
Book an
appointment for
a repeat Pap test
or colposcopy
Yes
Unsatisfactory
There was a
problem looking
at the cervical
cells
Book an
appointment for
a repeat Pap test
Yes
Presenter notes:
Who needs Pap tests?
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All women who have ever been sexually active (sexual intercourse
and intimate touching), regardless of sexual orientation, should have
regular Pap tests.
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Most women need a Pap test every two years.
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Even if a woman has had sexual contact just one time many years ago
she needs to continue getting regular Pap tests. A woman may be able
to stop at age 70. Talk to a doctor or nurse about what is best.
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Book an appointment with your doctor or nurse. To find a Pap test
clinic near you, visit TellEveryWoman.ca or call CervixCheck at 7888626 or 1-866-616-8805.
Who needs Pap tests?
• All women who have EVER
been sexually active (sexual
intercourse and intimate
genital touching), regardless
of sexual orientation
• Every 2 years
• Book an appointment with:
– regular doctor or nurse
– Pap test clinic listed at
TellEveryWoman.ca
Presenter notes:
Pap tests and pregnancy
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Pap tests performed during pregnancy have a high false positive rate, meaning that
the results may come back as abnormal when really the cervical cells are normal. This
can cause undue stress to the woman).
Screening during pregnancy is unnecessary if a woman has:
– had routine Pap tests prior to pregnancy
– no visual abnormalities on her cervix (to be confirmed by doctor or nurse)
NOTE: Pregnant women will need to be swabbed for other infections that involve
using a speculum.
Screening histories can be obtained by the woman herself by calling 788-8626 or toll
free at 1-866-616-8805 and requesting a copy to be mailed.
A screening history states:
– when & where each test was performed,
– who performed the test, and
– what the results have been since the year 2001.
Pap tests are not required just because a woman is pregnant. Pap tests are
recommended every two years. It’s essential to know a woman’s Pap history to make
an informed decision about whether or not a Pap test is recommended.
Pap tests and pregnancy
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High false positive rate
Pap test not necessary if:
–
Woman has had routine
screening prior to
pregnancy
–
The doctor or nurse does
not see any problems on a
woman’s cervix
Pap tests should occur every 2
years
To get a copy of your own
screening history call 788-8626
Presenter notes:
What is the HPV vaccine?
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Two HPV vaccines: Gardasil & Cervarix
– Gardasil protects against:
• HPV 16 & 18 which cause over 70% of cervical cancers
• HPV 6 & 11 which cause 90% of genital warts
– Cervarix protects against HPV 16 & 18
Gardasil is currently available at no charge to females in grade 6, females born on or
after January 1, 1997 or females from another jurisdiction who are already partway
through the immunization series.
The vaccine is most effective when given to females before they start having sexual
contact. If you receive Gardasil before exposure to HPV 16, 18, 6 and 11, it will be
almost 100% effective in preventing infections from these four types.
If a woman has previously been infected with one of these four types, the vaccine will
still protect against the remaining three types.
A woman will still need to have regular Pap tests as the vaccine does not protect
against ALL types of HPV that can cause cervical cancer.
Women can call their Public Health Nurse should they have more questions about the
Manitoba HPV Immunization Program.
What is the HPV vaccine?
• Protect against certain
types of HPV which cause
cervical cancer
• Vaccines do not treat
existing HPV infections
• Gardasil is free for females
in grade 6
• Still need regular Pap tests
Presenter notes:
When was your last Pap test?
• Not sure?
• Call 788-8626 to get
a screening history
report mailed to
you.
When was your last Pap test?
• Not sure?
• Call 788-8626 to get
a screening history
report mailed to
you.
Presenter notes:
Let’s review…
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HPV is transmitted through sexual intercourse and intimate
genital touching. HPV is very common.
Abnormal cervical cells are caused by HPV.
A Pap test looks for abnormal cervical cells on the cervix.
Treating abnormal cells can prevent cervical cancer.
Women who have ever been sexually active need to have regular
Pap tests every 2 years.
Women who receive the HPV vaccine still need regular Pap tests.
Women can visit their regular doctor or nurse for a Pap test or
visit TellEveryWoman.ca to find a location nearby.
There are many ways to review information: Q&A, True and
False, and other games. Please adapt to suit the needs of your
group.
Let’s review…
Presenter notes:
Any questions?
1.
Answer questions to the best of your ability.
2.
If you are at all unsure of how to respond please refer to the
resource materials or call the Recruitment & Health Promotion
Specialist at CervixCheck at 788-8626.
3.
Encourage your group to contact CervixCheck, CancerCare
Manitoba should they have questions or concerns:
a) Phone: 788-8626 or 1-866-616-8805
b) Website: TellEveryWoman.ca
4.
Remind the group of where they can access Pap tests in the
community.
Any questions?
Presenter notes:
Take away
To conclude the learning session and help solidify the information learned, ask your group
members one or more of the following questions:
1.
What is one thing you learned about cervical cancer screening that you did not
know before today?
2.
Name one person with whom you can share this information.
3.
Where can you go if you have questions about cervical cancer screening?
4.
Encourage your group to contact CervixCheck, CancerCare Manitoba should they
have questions or concerns:
a) Phone: 788-8626 or 1-866-616-8805
b) Website: TellEveryWoman.ca
Take away…
Presenter notes:
Remember…
• Pap tests help prevent cervical
cancer.
Remember…
• Pap tests
help
prevent
cervical
cancer.