Cervical cancer, a progressive disease, is the second most common cancer among Indian women. India accounts for 20 percent of the world’s burden of the disease. Cervical cancer is a slow growing cancer that occurs in the cells of the cervix. It takes about 3 to 7 years for precancerous lesions to develop into cancer,” says Dr Anuradha Panda, Obstetrician-gynecologist, Apollo Hospitals, Hyderabad. Most cervical cancers are linked to strains of human papillomavirus (HPV), a sexually transmitted infection. While Pap-smear and a co-test that includes Pap smear and HPV test, are not diagnostic tests, these help screen for abnormalities that require further testing for a certain diagnosis of cervical cancer.

 

Risk factors for cervical cancer include multiple sexual partners, a compromised immune system, sexually transmitted diseases, smoking and exposure to a certain miscarriage prevention drug.

 

What You Should Know About Cervical Cancer Screening
 

Screening tests: Pap smear, HPV test and a co-test, are cervical cancer screening tests that detect abnormalities in the cervix’s cells. Abnormal test results indicate the need for further testing.

• Pap smear involves taking cells from your cervix, which is the lower, narrow end of your uterus at the top of your vagina. While you may feel a little uncomfortable, Pap tests usually don’t hurt or cause severe pain.
• An HPV test examines a sample of cervix cells to see if they are infected with high-risk HPV strains.
• In certain cases, your doctor may also recommend a co-test (Pap smear and HPV) for better diagnosis. Co-test is usually performed when you are 30 years and above.
   

When To Get Screened: Cervical cancer screening is a crucial component of women’s healthcare. Regardless of how sexually active you are, you should begin routine screening at the age of 25. The frequency of cervical cancer screening and the tests you should have are determined by your age and medical history. “As per The Federation of Obstetric & Gynecological Societies of India, the right age to start a Pap test is 25 yrs. Under normal results, you should repeat the test in three years,” says Dr Panda.

 

If you are someone with a history of cervical cancer, HIV infection, a weaker immune system, or prenatal exposure to diethylstilbestrol (DES), you may require more regular screening, as recommended by your doctor.

 

Also, symptoms such as pelvic pain during intercourse, abnormal (watery, bloody) vaginal discharge or vaginal bleeding after intercourse is a sign that you need to consult a doctor immediately, and he or she may ask you to undergo cervical cancer screening.

 

How To Prepare For A Pap Or HPV Test

For two days before your Pap smear appointment, avoid sexual activity, douching, or using spermicidal preparations or any form of vaginal treatment. Abnormal cells may get washed away by these substances. “Secondly, do not schedule your Pap smear when you are menstruating,” advises Dr. Panda. The pH of your vagina changes in your periods and thus may interfere with the test results.

 

At the time of the test, you will be asked to undress from the waist down. You are asked to lie on the exam table at the doctor’s office with legs spread. The doctor introduces a speculum into the vagina. The speculum separates the walls of your vagina so your doctor can see your cervix clearly. When the speculum is inserted, you may feel pressure in your pelvic area. The doctor collects a small sample of cells from the cervix using a combination of extended-tip spatula with an endocervical brush. The procedure, overall, takes 10 minutes.

 

The collected sample of cells or specimen is transferred to a container containing a specific liquid to preserve the sample. The samples are taken to a lab and inspected under a microscope for analysis.

 

When To Stop Pap Smear Screening
Most doctors recommend stopping Pap smear by the age of 65. The rule of thumb is to check if you have three consistent negative results in the last 15 years, explains the doctor.

 

Are Pap Tests Needed After Hysterectomy?

• You do not need a routine Pap smear screening for benign disease.
• You do not require Pap testing, unless hysterectomy was performed because of cervical cancer or its precursors.
• You do not need a screening if you do not have a history of a high-grade precancerous lesion.