Cancer of the cervix or cervical cancer is a leading cause of female cancer deaths in India . Unlike many other cancers, cervical cancer occurs early and strikes at the productive period of a woman’s life. The incidence rises in 30–34 years of age and peaks at 55–65 years, with a median age of 38 years (age 21–67 years). However, it is largely preventable & there is actually a screening test and a vaccine available for its prevention. Being aware about it is half the battle won !
Common causes of Cervical Cancer & risk factors:
- Human Papilloma Virus ( a sexually transmitted infection )
- Multiple sexual partners
- Early onset of sexual activity
- Multiple childbirths
- HIV infection
- Immunocompromised patients
- Low socio economic status
- Poor hygiene
- Diet low in antioxidants
Precancerous stages may not give any symptoms but are picked up by routine screening tests of Pap’s smear & HPV- DNA testing. Advanced stages may present with abnormal vaginal bleeding, foul smelling discharge vaginally, Bleeding after intercourse or after menopause.
Screening & Diagnosis :
Screening for cervical cancer is done by Pap’s smear & HPV- DNA testing. Pap’s smear is one of the greatest success stories of preventive medicine. It is an OPD procedure done by inserting a speculum into the vagina & removing cells from cervix with the help of a brush or a spatula. The cells are then collected in a liquid medium or spread on a glass slide & sent for microscopic examination.
Diagnosis of cervical cancer is confirmed by visual examination of cervix, pap’s smear , colposcopy & cervix biopsy.
What is a Pap’s Smear Test ?
A Pap’s test, is a procedure to test for cervical cancer in women. It involves widening the vaginal canal with help of an instrument called a speculum & collecting cells from the cervix i.e the lower, narrow end of the uterus. These cells are placed into a solution which is sent to a lab for testing.
Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in the cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.
What Do the Results of a Pap Test Mean?
A normal Pap test means the cells from the cervix look normal & only routine screening schedule needs to be followed . An abnormal result means the cells do not look normal & further investigation is needed to confirm/ refute the diagnosis. Sometimes repeat Pap tests are needed. Different tests also may need to be done, such as a Colposcopy (the use of a special microscope to examine the cervix and vagina) and a Cervix biopsy. There are many causes for abnormal Pap test results, including infection, inflammation related to using a diaphragm, and changes related to your menstrual cycle. Your doctor will evaluate the results to determine if further testing is necessary.
How Often Should I Get a Pep Test?
Pap screen testing should begin at age 21. Routine screening is recommended every three years for women 21-65 years old. For women 30 to 65 years who have a normal Pap test with a negative HPV test, screening can be done every five years. Most women can stop having Pap smears after age 65 to 70 as long as they have had three negative tests within the past 10 years.
You may not need to have a Pap smear if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap smear, cervical cancer, or other pelvic cancer. Discuss this with your doctor.
What Symptoms Should I Watch For Between Pep Tests?
Precancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap test are usually required.
The most common symptom of cancer or a pre-cancerous condition is abnormal bleeding. Bleeding may occur in between regular menstrual periods, or it may occur after sexual intercourse or douching. Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms are not sure signs of cancer. But be sure to see your doctor if any of these symptoms develop.
How To Prepare For The Test?
Tell your doctor or nurse about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results.Also tell your doctor or nurse if you:
- Have had an abnormal Pap smear
- Might be pregnant
Do not do the following for 24 hours before the test:
- Douche (douching should never be done)
- Have intercourse
- Use tampons
Avoid scheduling your Pap smear while you have your period (are menstruating). Blood may make the Pap smear results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your doctor will determine if the Pap smear can still be done.
Preventive vaccination against cervical cancer:
Vaccination is against the various strains of HPV & provides reliable protection against cervical cancer. There are 2 types of vaccines available ( a bivalent & a quadrivalent vaccine ), both given in 3 doses over a period of 6 months. The recommended age for initiation of vaccination is 9–12 years. Catch-up vaccination is permitted up to the age of 26 years . Women who have been vaccinated should still undergo routine screening with Pap’s smear.
The Author, Dr. Smita Vats is practising as a Consultant Gynaecologist and Laparoscopic Surgeon in Gurgaon.She is one of the Best Gynaecologist in Gurgaon and a visiting consultant at various esteemed Hospitals in Gurgaon including Artemis Hospital, Cloud nine Hospital, Paras Hospital & GNH Hospital Gurgaon.