This way you can detect cervical cancer in time

As a woman in the Netherlands, from the age of 30, you will receive a call every 5 years to have a Pap smear made by your GP. This is a free cervical cancer screening program that tests for the presence of the HPV virus. It is not mandatory to be screened, but it is super important. Participating in the population screening can prevent the disease. Yet only half of the women take up her invitation.

Do you find it scary to have a Pap smear done? Or do you think it is not necessary to test because you have no complaints? Then read on.

The importance of participating

Every year, approximately 800 women in the Netherlands are diagnosed with cervical cancer and more than a quarter do not survive. This nasty form of cancer is usually the result of an infection with the HPV virus. This stands for the human papilloma virus and is sexually transmitted.

As many as 8 in 10 people will develop HPV at some point in their lives. Yes, you read that right, men too! They usually don’t feel this, they only carry the virus. HPV is not an STD, but it is extremely contagious. The virus settles around the genitals and you can even contract it by lying against each other.

Abnormal cells

Now there are more than 100 different types of HPV: some can cause warts or genital infections, and others can cause cervical cancer. That’s why you better be one step ahead of this virus! A positive HPV test only shows whether someone is a carrier of the virus.

To know whether you have cervical cancer, the smear must be tested for abnormal cells by means of cytology. Are there any deviations from this? Then you may be treated immediately and cervical cancer can be prevented.

Friendly reminder

That is why it is very important to respond to the call for a smear, or to take the initiative yourself to have a smear made earlier. Do you suffer from sporadic blood loss or do you often have problems with your stomach? Then it can’t hurt to ring the bell earlier.

Because only half of the women make use of her invitation, the KWF draws attention to the importance of participating with a ‘friendly reminder’. It reduces the chance of getting cervical cancer or dying from the disease. And it costs nothing at all, you can only save a lot of trouble with it.

Usually like this

Research by the RIVM shows that there are various reasons for not participating. For example, it can have a practical reason: the invitation ends up at the bottom of a pile and making the appointment is forgotten. But also: fear of the research itself, or of the results. While there is nothing to be afraid of.

The exam is like a visit to the dentist – usually in a jiffy. And you better hear the result as soon as possible. It usually takes another 10 to 15 years before moderate to severe abnormalities can develop into cervical cancer. So if you catch it early, the chance of successful treatment is many times greater.

How does such a smear work?

Making a smear takes about 10 minutes. It is important that you relax your body, because then the smear can be made as well as possible. They do this using a duckbill (well, it’s no different). A small brush is then inserted and rotated to remove mucus from the cervix.

The mucus contains cells that are removed for testing. Making a smear does not hurt, but pleasant is different. In most women the result is good and no abnormalities are found: then you have PAP1. Below you will find what the different PAP stages mean and what action is taken.


This is the normal cell image. No abnormalities are seen.


A few cells look different than usual. You will be called back to have a new Pap smear after six months.


A small cell abnormality can be seen. You will be referred to the gynecologist for further examination.


The cells are slightly more abnormal than PAP3A. You will be referred to the gynecologist and treatment may be required.


The cells are even more abnormal. High chance of treatment.


Highly abnormal cells, this can mean cervical cancer, but it doesn’t have to. Surgery and further treatment are needed.

On to the gynecologist

If you have a PAP2 or higher, you will be monitored to see how the virus is developing.

If you have PAP3 or higher, the gynecologist will examine the cervix further with a kind of microscope. A suitable treatment is selected depending on the abnormality.

For example, it is possible that the gynecologist removes a layer of the cervix. After the abnormal cells in that layer have been removed, new and healthy cells develop in that place. In most women, the Pap smear returns to normal after treatment and no abnormalities are found.

Preventing Cervical Cancer

The call for the population screening is really an appointment you don’t want to miss. Furthermore, a good resistance does wonders for your health. And a good resistance gives the HPV virus less chance to develop further. So: don’t smoke, eat healthy and exercise a lot (what’s new).

Prevention is better than cure, right?

This article previously appeared on the website of our colleagues at

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This way you can detect cervical cancer in time