Cervical cancer (cancer of the lowermost part of the uterus) is a leading cause of deaths in the Indian subcontinent and is the commonest female cancer in developing countries even today.
We have all now heard of the vaccine, but a majority of us belong to a generation which had no access to it. And we also know that the vaccine does not give 100% protection. Therefore, the importance of screening to detect early cervical cancer cannot be disputed.
What is screening?
Screening is looking for cancer before a person has any symptoms. Screening can help find cancer at any stage. When cancer or abnormal tissue is found early, it may be easier to treat. By the time symptoms appear, it may be too late and cancer may have begun to spread.
Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through certain changes known as dysplasia, in which cells that are abnormal begin to appear in the cervical tissue. Later, cancer cells begin to grow and spread more deeply into the cervix and later to surrounding areas.
What is the PAP test?
The PAP test is a simple and routine test to detect cellular changes which precede the development of cervical cancer. It can be performed in any clinic and does not require anaesthesia. The report is available in about a week’s time.
Regular use of the Pap test among women has greatly reduced the incidence of cervical cancer in developed countries.
What does an abnormal PAP report mean?
Abnormal cell changes which occur due to HPV infection can be picked up and reported.
These abnormal cells show early precancerous changes called dysplasia or cervical epithelial neoplasia ( CIN ). Dysplasia and CIN are graded as mild, moderate or severe depending on the severity of the changes. Mild dysplasia (CIN 1) usually tends to go away on its own (without any treatment). Moderate (CIN 2) and severe (CIN 3) dysplasia indicate more serious changes.
Such patients are notified and are then referred for further tests to get more a detailed diagnosis and so that appropriate remedial treatment may be instituted.
What has HPV infection to do with cervical cancer ?
HPV or the Human Papilloma Virus infection is a sexually transmitted infection and is almost always a necessary prerequisite to cervical cancer. Certain strains of the virus are capable of causing cellular changes which may lead to the later development of cancer. The good news is that if you have regular Pap smear tests, it is unlikely that severe precancerous changes will occur because it takes many years for these types of cervical cell changes to develop into cancer.
Also, not all patients of HPV infection develop cancer.
When should I have a Pap test?
- Have your first Pap test about 3 years after you have sex for the first time, or when you reach age 21 (whichever comes first).
- Repeat Pap tests every 1 to 3 years. If you are 30 or older, an HPV test may also be done along with the Pap test.
What is liquid cytology and how is it different from a PAP test ?
Liquid cytology is a relatively new technique for screening for precancerous cells and offers some advantage over the PAP test that it is technically superior and also that the same sample can be used to test for HPV DNA testing (infection with HPV). It has been approved by the FDA and has replaced the PAP test in many developed countries for cervical cancer screening.
How does the cervical cancer vaccine work?
The cervical cancer vaccine works by protecting against infection by certain cancer causing strains of HPV. The vaccine works best when given to women who have not yet initiated sexual activity. If she is already infected, the vaccine cannot change that.
Do we all need to take the vaccine ?
The USFDA has approved the vaccine for women and girls between the ages 9 and 26 .There are many more aspects to this vaccine and a detailed counselling is important before taking the vaccine.
What we offer at Gyneguide :
Group Counselling sessions covering the following aspects:
Cervical cancer screening by the liquid cytology technique with HPV DNA testing (optional), reports in a weeks’ time.
Detailed counselling about cervical cancer screening and vaccination.
Evaluation of the report and counselling re abnormal reports if any.