Cervical Cancer: Benefits of an Early Diagnosis

Globally, cervical cancer is the fourth most common type of cancer among women. However, early screening and primary prevention can help decrease the burden on healthcare and mortality rates. The thought of cervical cancer is particularly alarming for women since it is one of the major causes behind all cancer-related deaths among women. According to WHO, “cervical cancer is caused by sexually acquired infection with Human Papillomavirus (HPV). Most people are infected with HPV shortly after the onset of sexual activity”.

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However, if detected early, most cervical cancer cases can be managed well. During the initial stages, there are no signs to tell a woman that she may be at risk. There are many tests used for diagnosing cervical cancer. Some such tests are:

Cervical Smear Test

The PAP smear test is the most common test to detect early cell changes leading to cervical cancer. It involves collecting a sample of cells from the cervix.

By looking at the smear, experts can confirm whether the cervix is normal, healthy, or abnormal. The presence of abnormal cells suggests that cancer may develop in the future.

How is it done?

The smear test is a simple outpatient procedure where the gynaecologist scrapes some of the cells from the cervix (the neck of the uterus) and smears it on a glass slide for examination.

After the test

  • It takes 3-4 days to get the results from the lab. If the smear test is standard (as it is in most cases), it should be repeated after three years.
  • If the test discloses some “abnormalities,” this usually means that some changes have occurred in the cells, which, if left untreated, could develop into cancer after many years. Remember, most women who have had an abnormal smear test are successfully treated.
  • Once treatment starts, it will be necessary to repeat the test after some months. If the subsequent smear tests are regular, then the tests should be done every three years.
  • If the subsequent smear tests are not regular and continue to show some abnormalities, it will be necessary to investigate further.

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Colposcopy

A Colposcopy examination is an outpatient procedure, just like a smear test. It is an in-depth examination of the cervix through a special microscope called a colposcope. A colposcope acts like a magnifying glass with light, allowing the doctor to look closely at the cervix.

How is it done?

Colposcopy is usually indicated when the routine cervical screening test, i.e., Pap smear test, has picked up abnormal cells from the cervix.

A solution is applied to the cervix, which will cause the affected areas to turn white. The cervix is then viewed through the colposcope, placed just outside the vagina. If there are any abnormal areas on the cervix, a tiny tissue sample is taken (biopsy) and sent to the lab for further testing.

After the test

Some tissues are taken from the cervix; you may experience mild cramping or light bleeding for a few days, which can be relieved by any anti-inflammatory medication. It is advisable to abstain from sexual intercourse for a few days after a biopsy.

When to get the test done?

  • Women between the ages of 20 – 60 should do the test every three years.
  • Women who have excess / recurrent attacks of vaginal discharge or bleeding after sexual intercourse.
  • It should be done within ten days of the onset of periods.
For more information, please consult our team of Gynaecologists. To book an appointment, call 1800 419 1397.

Prevention of Cervical Cancer (HPV Vaccine)

What is HPV ?

HPV (Human Papilloma Virus) is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in late teens and early 20s.

There are many strains (types) of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers – like cancers of the anus, penis, vagina, and vulva (area around the opening of the vagina) and oropharynx (back of throat including base of tongue and tonsils). Other types of HPV can cause warts in the genital areas of men and women. These genital warts are not life-threatening. However, they can cause emotional stress and the treatment can be very uncomfortable.

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Pic courtesy:  http://www.virology.wisc.edu/virusworld/viruslist.php?virus=hpv

Why are HPV vaccines important ?

The vaccines target the HPV types that most commonly cause cervical cancer. One of the two currently available vaccines also protects against genital warts caused by HPV. Both vaccines are highly effective in preventing specific HPV types.

What is the vaccination schedule ?

The schedule is three doses of intramuscular injections, administered over a period of six months.

Who needs to get vaccinated ?

HPV vaccination is recommended for girls and women (9 to 45 years of age).

Can pregnant women take the vaccine ?

The vaccines are not recommended for pregnant women. Although studies show that HPV vaccines do not cause problems for babies born to women who received HPV vaccination when pregnant, more research is still needed. If the patient becomes pregnant in the middle of the vaccine series, then the doses should be completed after delivery. Vaccination can be given during breastfeeding.

Should girls and women be screened for cervical cancer before getting vaccinated?

Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all three shots of the HPV vaccine.

How effective is the vaccination ?

It is a prophylactic vaccine. As with any vaccine, a protective immune response may not be elicited in all cases. The vaccines are less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccines can prevent HPV only before a person is exposed to it. HPV vaccines do not treat existing HPV infections or HPV-associated diseases.

How long does the vaccine protection last ?

Research suggests that the vaccine protection is long-lasting. Current studies (with up to about seven years of follow-up data) indicate that the vaccines are effective long term, with no evidence of decreasing immunity.

Do the vaccines protect against all HPV types ?

The vaccines do not protect against all HPV types. They are ineffective in about 30% of cervical cancers. It is important, therefore, for women to continue regular screening (Pap tests) for cervical cancer.

How safe is the vaccine ?

Both vaccines have been licensed by the Food and Drug Administration (FDA) and approved by Centre for Disease Control (CDC) as safe and effective. Common mild adverse events reported during these studies include pain at the injection site, fever, dizziness and nausea.

In what other ways can women prevent cervical cancer ?

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.