Cervical cancer starts in the uterine cervix, which connects the vagina (birth canal) to the upper part of the uterus. All women are at risk of developing this disease.
A pap smear procedure is a screening test for cervical cancer
Cancer is an abnormal growth of cells in the body. Cervical cancer starts in the uterine cervix, which connects the vagina (birth canal) to the upper part of the uterus.
All women are at risk of developing this disease. It occurs most often in people over the age of 30. Long-lasting infection with certain strains of the human papilloma virus is the main cause of cervical cancer. HPV virus can be passed from one person to another during sexual intercourse.
Early symptoms of cervical cancer are increased and sometimes foul-smelling vaginal discharge, intermenstrual bleeding (bleeding in between regular periods), dyspareunia (pain during sexual intercourse), and post-coital bleeding (bleeding after intercourse). Sometimes patients may present with prolonged menstrual cycles or even heavy menstrual flow.
It is disappointing to have a high incidence of this cancer in the era of screening tests like pap smear tests and the HPV vaccine, which can help prevent cervical cancer. Screening can also help in the early diagnosis of cervical cancer, when it is completely treatable.
Understanding Pap Smear
A pap smear procedure is a screening test for cervical cancer. This is an OPD procedure where the doctor examines the cervix and collects a sample of the cells of the cervix with the help of a swab or spatula. These cells were then smeared on a glass slide. After chemical fixation, these slides were examined by a cytologist under a microscope. The doctor should also use the sample for HPV testing in the same sitting. The results of this test can be either negative (normal) or positive (abnormal), depending on the presence of any precancerous or cancerous cells in your cervix. Not all abnormal tests are conclusive for malignancy but suggest further evaluation in the form of either a repeat test or colposcopy, depending on age. If suspicion is high, usually a biopsy is required for further confirmation. Pap testing should be avoided during menstruation.
Women between the age of 21 to 29 should undergo a Pap test every three years. Although Pap test is preferred for all women, but women between the age of 25 to 29 can also take HPV testing. Women aged between 30 to 65 have three alternatives for testing. Every 5 years, they can get a Pap and an HPV test (co-testing). Alternatively, they can receive HPV testing once every five years or a Pap testing once every three year.
HPV vaccination is recommended for all persons through age 9-26 who were not adequately vaccinated earlier. Although for all adults ages 27 through 45, clinicians may consider discussing with their patients in this age group who were not adequately vaccinated earlier whether HPV vaccination is right for them. It is advisable that pregnant women should avoid taking this vaccination.
With both of these tests, most cervical cancers can be either prevented or treated at a very early stage. The advantages of screening and early detection are simplicity of treatment and lesser financial burden on the family, as screen-detected cancers can be treated mostly with single-modal treatment (i.e., surgery alone) and provide better long-term survival.
(Dr. Anadi Pachaury, Consultant Surgical Oncology at Manipal Hospital, Dwarka)
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