Cervical Cancer

Cervical Cancer


After the development of a screening program for cervical cancer, the incidences of cervical cancer have substantially declined during the last decades. Finding cervical cancer, treating, and even preventing the early development are the main benefits of the proper screening test.

Cervical cancer is unique among other types of cancer because of its direct relation with a viral infection known as the Human Papilloma Virus. Having the vaccine against the human papilloma virus is a very effective way of preventing the development of cervical cancer. The best time to get vaccinated is before being sexually active. According to the recent recommendations, the best time for the human papilloma virus vaccine is at the age of 11. Regular screening tests are very important.

Two types of cervical cancer screening tests

  • Pap smear: It’s a very effective and fast test to detect any cellular changes in the cervix. Usually the doctor will take the sample from the cervix and send it to lab to be examined. This screening test helps to diagnose and treat any suspicious cells before they become cancerous.

  • Human papilloma virus test: This screening test aims at diagnosing the infection caused by the human papilloma virus, thus treating it early before it causes cancerous changes on the cells. This test can be used in combination with a Pap Smear.

The recent guidelines regarding the screening for cervical cancer

The following are the recent guidelines regarding the best time and method to screen for cervical cancer:

  • The ideal time to start a cervical cancer screening test is at the age of 21.

  • Women between ages of 21 and 29 must have the cervical screening test at least once every three years. The best screening test for this age group is the pap smear. There is no need to have a human papilloma virus test unless the pap smear test is abnormal.

  • Women between ages of 30 and 65 should have the recommended screening test at least once every five years. The best screening method for this age group is both the pap smear and the human papilloma virus test.

  • Women over the age of 65 with no history of previous abnormal screening results can stop having the screening test.

  • Any woman who had a surgery to remove her uterus and cervix can stop having the screening test.

  • Having the human papilloma virus vaccine does not give a women 100% protection from cervical cancer; the patient should continue her screening program as recommended for her age.

  • Any woman in the high risk group for cervical cancer, such as unvaccinated women or families with history of cervical cancer, should follow another special screening program depending on her risk. Patients should consult their doctor to address this issue.

  • Recently, it’s recommended not to have the pap smear yearly, as the cervical cancer takes more than ten years to develop, and the procedure of pap smears is time and money consumed without a high yield outcome.

Pap Smear

A pap smear is basically a screening test for the diseases of cervix. The cervix is the lower part of the uterus and it opens into the vagina. Cells are scraped from the opening of the cervix and tested under the microscope for diseases.

Overview of the Pap Smear

“Pap smear” is the short name for Papanicolaou test; Papanicolaou is the name of the scientist who invented the test. A pap smear is basically a screening test for cancer of the cervix. It detects the potentially precancerous and cancerous changes in the cervix. The changes can be treated if detected in time, hence the disease can be prevented.

How pap smear test is performed?

The patient is asked to lie on the bed with feet in the stirrups. An instruments known as the speculum is inserted into the vagina and opened slightly. It allows the doctor or the nurse to see inside the cervix via the vagina. Cells from the cervix area are gently scraped and sent to the lab for microscopic examinations.

Are there any preparations for pap smear test?

Estrogen or progestin containing drugs may interfere with test results. So it is wise to inform the doctor or nurse about all the prescription and non-prescription drugs that are being taken before the test. Previous history of pap smear tests should be reported as well. The doctor also should be advised if you are or could be pregnant.

It is recommended to avoid a bath, douching, tampons, or having intercourse 24 hours before the test. Periods might affect the accuracy of the pap smear test, so scheduling for the test should be done accordingly.

How will the test feel?

A sense of pressure might be felt during the exam. Some amount of menstruation-like discomfort and bleeding may be noted after the exam.

When should the test be performed?

The pap smear is done to screen for cervical cancer. Early detection leads to early treatment and cure. It is recommended that the screening be started at the age of 21. You should consult your doctor to confirm how many tests you need and at what intervals should you have them.

What is the Normal result?

A normal test result means that there are no abnormal or cancerous cells present. However, you should consult your doctor to understand the meaning of the test result.

What is an Abnormal result?

The abnormal results are grouped into various categories. They include:

  • ASGUS – Atypical cells of uncertain significance

  • LSIL - Low grade dysplasia

  • HSIL - High grade dysplasia

  • CIS – Carcinoma in situ

  • ASC-H – Atypical squamous cells with HSIL

  • AGC – Atypical glandular cells

The Doctor should be consulted for further information about abnormal test results. A follow-up test or further testing might be needed in such cases.