Cervical cancer screening The main goal of cervical cancer screening is to detect precancerous changes, which, if not given attention to, may lead to cancer. It has been found that screening works only when there is a well-organized system for follow-up and treatment. Females who are found to have abnormalities during their screening sessions need a robust follow-up and diagnosis regimen, followed by an effective treatment plan, to prevent the development of cancer or to treat cancer at an early stage. Screening aims at looking for a cancer before any symptoms emerge in an individual. This way cancer can be detected at an early stage as when the abnormal tissue or cancer is found early, it may be easier to treat. It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
**The following tests may be used to diagnose cervical cancer: **
- The Pap test or Pap smear: The Pap smear is one of the tests that has been used in large populations and that has been shown to reduce cervical cancer incidence and mortality. The test looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. If you are getting a Pap test, the cells will be checked to see if they look normal.**
- The HPV test: This test looks for the virus (human papillomavirus) that can cause these cell changes. The sample is tested for the presence of 13–14 of the most common high-risk category HPV types. If you are getting an HPV test, the cells will be tested for HPV. We would like to share that both the tests can be performed in a doctor’s office or clinic. While the doctor is conducting the Pap test, you will see him using a plastic or a metal instrument, called a speculum, to widen your vagina. This aids the doctor in examining the vagina and the cervix and helps collect a few cells and mucus from the cervix and the area around it. The cells are then sent to a laboratory.
- Endocervical curettage: A procedure to collect cells or tissue from the cervical canal using a curette (spoon-shaped instrument). Tissue samples are taken and checked under a microscope for signs of cancer. This procedure is sometimes done at the same time as a colposcopy.
- Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) or a brush and checked under a microscope for signs of disease.
- Biopsy: If abnormal cells are found in a Pap test, the doctor may do a biopsy. A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office. A woman may need to go to a hospital for a cervical cone biopsy (removal of a larger, cone-shaped sample of cervical tissue).
Studies show that screening for cervical cancer helps decrease the number of deaths from the disease. Regular screening of women between the ages of 21 and 65 years with the Pap test decreases their chance of dying from cervical cancer.
When to get screening done? A commonly asked question on screening is how often one should have cervical cancer screening. This decision is best made by you and your doctor. Listed below are scenarios basis the age groups, one might need to consider: –
If You fall between 21 to 29 Years age bracket – You should get Pap tests at age 21. If your Pap test result is normal, your physician may tell you that you can wait three years until your next Pap test.
If You fall between 30 to 65 Years age bracket – You must discuss with your physician about the various testing options and the one that suits you best: —
- A Pap test only – If your result is normal, your doctor may suggest three years wait until your next Pap test.
- An HPV test only – If your result is normal, your doctor may suggest five years wait until your next screening test.
- Co-testing- This involves an HPV test along with the Pap test. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test. It is important to note here that pap smear test is not a helpful screening test for cervical cancer in women younger than 21 years or women who have had a total hysterectomy (surgery to remove the uterus and cervix) for a condition that is not cancer. It is also not effective in women who are aged 65 years or older and have had a Pap test result that shows no abnormal cells. It is very likely that these women will have abnormal Pap test results in the future.
How to Prepare for Your Pap or HPV Test You must avoid scheduling the test during your period. If you are going to have a test in the next two days— • Avoid rinsing the vagina with water or another fluid. • Do not use tampon. • Refrain from having sex. • Do not use any birth control foam, cream, or jelly. • Do not use a medicine or apply any kind of cream in your vagina.
Test Results Waiting for your test results might be a bit difficult, but there are chances that it can take as long as three weeks to receive your test results. During this time fill yourself with positive thoughts and make yourself busy with things you love the most. In case, your test shows that something is not right, your doctor will contact you and figure out how best to follow up. There could be many reasons as to why test results might not be normal. It usually does not mean you have cancer. In Case your test results appear abnormal, do not panic, and retain your calm as it has been found that many women have abnormal cervical cancer screening results. An abnormal result does not always explain the possibility of cancer. Many a times, cervical cell changes go back to a normal state on their own and in case they do not, it often takes several years for even high-grade changes to become cancer. Go for an additional testing in case you have an abnormal screening test result and analyse your reports for the presence of high-grade changes or the presence of cancer. Sometimes, only repeat testing is needed. In other cases, colposcopy and cervical biopsy may be recommended to find out how severe the changes really are. If results of follow-up tests indicate high-grade changes, you may need treatment to remove the abnormal cells. In most scenarios, a planned treatment approach ensures prevention of cervical cancer from spreading further. It is important to discuss with your doctor right away and learn more about your test results and see if any treatment action is required. If your test results are normal, your chance of getting cervical cancer in the next few years is low. Your doctor may tell you that you can wait several years for your next screening test. But you should still go to the doctor regularly for a check-up.
After cervical cancer has been diagnosed, tests are done to find out if cancer cells have spread within the cervix or to other parts of the body. The process used to find out if cancer has spread within the cervix or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
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