Prevention of cancer cervix:
The cervix is the bottom part of the uterus; it opens into the vagina
Cervical cancer happens when normal cells in the cervix change into abnormal cells and grow out of control.
There are two types of cervical cancer, “squamous cell carcinoma” and “adenocarcinoma.”
Cervical cancer screening tests:
Screening tests can find cervical cancer and precancer in the early stages when it can be treated, and thus may reduce the number of people who develop cervical cancer as well as the number of deaths due to the disease.
There are two types of screening test for cervical cancer:
- The Papanicolaou or “Pap” test (sometimes called a “Pap smear”)
- The human papillomavirus or “HPV” test
Or a Combination of both Tests
The most important risk factor for cervical cancer is infection with the human papillomavirus (HPV).
There are over 100 different types of HPV; however, most types of HPV do not cause cancer.
At least 80 percent of women are exposed to the HPV virus during their lifetime. Most of the time, the body’s immune system gets rid of the virus before it does harm.
HPV types are divided into high or low risk for causing cervical cancer.
- Low-risk HPV types – For example HPV types 6 and 11 can cause genital warts and are low-risk types because they rarely cause cervical cancer.
- High-risk HPV types – High-risk HPV types may cause cervical cancer in some people.
Although most people who are infected with the high-risk HPV types do not develop cervical cancer, those who repeatedly test positive for high-risk HPV are at a higher risk of cervical cancer.
HPV types 16 and 18 are two of the high-risk types.
How does HPV infection happen?
HPV is spread by direct skin-to-skin contact, including vaginal intercourse, oral sex, anal sex, or any other contact involving the genital area (eg, hand-to-genital contact).
So HPV is transmitted by sexual contact
Condoms provide only partial protection, since they do not cover all of the skin in the genital area.
It is not possible to become infected with HPV by touching an object, such as a toilet seat.
Course of HPV infection:
Most HPV infections are temporary and resolve within two years. People whose immune system cannot clear the virus (10-20%) are at higher risk of developing precancer or cancer. This usually takes many years.
Risk of cervical cancer increases in smokers, and those having a medical condition (or taking a medication) that weakens the immune system.
Most people who are infected with HPV have no signs or symptoms.
How to reduce the risk of cervical cancer?
- A vaccine to help prevent infection with some high-risk types of HPV is recommended for all children ages 11 to 12 years, but it can be given as early as age 9. “Catch-up” vaccination is recommended for all people up to 26 years of age who have not yet received it, but it can be given up to age 45.
- Cervical cancer screening (even for those who are vaccinated)
- Smoking cessation
Cervical cancer screening
1-Pap test — The Pap test (sometimes called a “Pap smear”) is a method of examining cells from the cervix. Another term for a Pap test is “cervical cytology.”
For a Pap test, the provider will do a pelvic examination using a device called a speculum to open the vagina. Then they will use a small brush or spatula to collect cells from the cervix. This may be uncomfortable but usually is not painful. The cells are added to a container with preservative fluid or smeared on a glass slide for examination.
2-HPV test — Like a Pap test, the human papillomavirus (HPV) test is done during a pelvic examination, using a small brush to collect a sample from the cervix. HPV tests do not test for all different types of HPV. They only test for the strains of HPV that have a high risk for causing cervical cancer; a positive result indicates that one or more of these strains were found. Sometimes, the lab will specifically report if you have either of the two highest-risk HPV types, known as HPV 16 and HPV 18. This is called “genotyping.”
3-Combination test — This involves doing a Pap and HPV test at the same time; it is also called “co-testing.”
Screening tests can be done at any time during your menstrual cycle. However, not during the period.
Who should be screened?
The goal is to start screening at the point at which the benefits of screening are likely to outweigh the risks.
People who have received the vaccine should also be screened , since vaccines prevent the most common HPV infections but not all HPV infections.
Before age 21:
In healthy people, screening is not recommended
Age 21 to 29 —
- Screening can start in the age of 25 every 3 years with pap smear
Age 30 to 65
- HPV-only testing also called primary HPV testing) every five years if all results are normal
- “Co-testing” (both Pap and HPV testing) every five years
- A Pap test every three years if all results are normal
After age 65 — Most women with no risk factors can stop having cervical cancer screening after the age of 65
- Those who had all normal screening tests on a regular basis in the past.
- Those who have had at least three normal Pap tests in a row or two normal co-tests (combination Pap and HPV tests) over the past 10 years, with the most recent test within the past 5 years.
Some Womwn with Risk factors need to continue having cervical cancer screening beyond the age of 65 if:
- They had an abnormal Pap test, an abnormal HPV test, or treatment for cancer or precancerous cells of the cervix, vagina, vulva, or anus.
- They have HIV infection or another condition that suppresses the immune system.
- They were exposed to diethylstilbestrol (DES) the womb – DES is (a drug that was given to many women before 1981 to prevent pregnancy complications).
After hysterectomy (surgical removal of the uterus and sometimes the cervix
- If cervix was removed, no need for further screening.
- If cevix is not removed ( regular guidelines should be followed)
SCREENING TEST RESULTS
Pap test — If a Pap test was done as part of your cervical cancer screening, the results from your Pap test will be available a few weeks after your visit. Pap test results may be reported as:
- Negative– Pap tests that have no abnormal, precancerous, or cancerous cells are labeled as negative for intraepithelial lesion or malignancy.
- Abnormal results– Cervical cells may appear abnormal for a variety of reasons. For example, you may have a cervical infection or you may have a precancerous area or even cervical cancer.
HPV test — If a human papillomavirus (HPV) test was done as part of your cervical cancer screening, the results will be available a few weeks after your visit. The results may be reported as:
- Negative– There are no high-risk HPV strains present.
- Positive– There are high-risk HPV strains present. Some labs will specify if the highest-risk HPV types (HPV 16 or HPV 18) are present.
Follow-up testing — If your Pap or HPV test results are abnormal, you may need follow-up testing or colposcopy ( checking the cervix with a microscope) and taking biopsy-depending on the abnormality.
Cervical cancer screening is easy and widely available and is the most important step in preventing cervical cancer and saving lives!