Cervical Cancer and Paps Smear
Cervical cancer is preventable. Yet, it is the second leading cause of death in most countries.
Symptoms will usually be irregular or increased vaginal bleeding or post coital staining. The precise cause of cervical cancer is not known. Women who have multiple sex partners are at increased risk, and the disease is more frequent in young prostitutes. Those who started intercourse at ages 14 or 15 years have higher risk than those who started intercourse over 20 years. Also, women married to men whose previous wives had developed cervical cancer had threefold increase frequency of the disease. The occurrence of diseases such as gonorrhea has also been shown to be associated with the frequency of cervical carcinoma. Alteration to immune function increases the risk of cancer, i.e. HIV infection. Certain viruses, such as papillomavirus, herpesvirus and cytomegalovirus have also been implicated.
The Pap smear has been widely used for about 50 years to screen women for cancerous and pre-cancerous cervical diseases. It has been effective to reduce the frequency of invasive cancer of the cervix by 50% . However, it is estimated that only 5-12 percent of the recommended target population has ever been screened in our country and those are usually women in the cities). The Pap smear is an office procedure that usually takes only a few minutes. It is done at a time when women are not having menstrual bleeding. A speculum is the instrument used in exposing the cervix, by placing in the vaginal canal. Samples are obtained using cytobrush, spatula or cotton swab. The sample is smeared on a slide and placed in a fixative. The slide will then be interpreted by a pathologist. Usually, in 3-7 days results are released.
The American College of Obstetrics and Gynecology and International Academy of Cytology recommend that Pap smear start at the age of 18 years or when the individual becomes sexually active, and continue annually indefinitely.
There are also newer diagnostic technologies that aim to decrease the false negative (chances of the test being negative when it is actually positive) rate of the conventional Pap smear:
- Liquid Based Cytology (thin layer technologies)
- Thin Prep
- Autocyte
- Human Papilloma Virus (HPV) Testing
- Computer Assisted Screening (Screening Automation)
Only the first two diagnostic tests are currently available in most big hospitals.
Again, cervical cancer is preventable and the standard way to screen for the disease is by having an annual pap smear. It is a simple procedure that takes only a few minutes, but can save years in most women lives. Women do not have to wait for symptoms of irregular vaginal bleeding nor post coital staining to have themselves screened for cervical cancer. Even prior to the occurrence of the symptoms, the Pap smear and any of the newer technologies will be able to detect pre-cancerous cells.
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