Cervical cancer is the fourth most common cancer among women
6 January 2019| Last updated on 7 January 2019
The main causative agent are high-risk strains of the Human papilloma virus (HPV) which causes the changes in cells of cervix.
Unlike ovarian cancer, which is usually detected in more advanced stages, cervical cancer can be detected and treated early on. There are two tests that can be offered to screen against cervical cancer: the Pap smear and HPV testing.
Precancerous changes can be detected and caught early on by Papsmear. Moreover, the presence of HPV can be detected prior to the development of precancerous changes by HPV testing.
The Pap smear or Papanicolau smear involves collecting the cells of the cervix-the neck of the womb that is at the higher portion of the vagina.
There are two methods of Pap smear: traditional and liquid-based cytology (LBC).
While the traditional method involves collection of the cells and smearing them on a glass slide, the LBC involves collecting the cells using a cytobrush and submerging the brush in a fluid medium, thereby storing the cells in the liquid. One of the advantage of LBC is that the same sample taken can be used for co-testing HPV.
The policy on frequency of Pap smear testing varies from country to country. Here in UAE, the recommended schedule is once every 3 years starting at the age of 25 until 65. However, for patients with a history of abnormal cells, monitoring may require smears to be done more frequently.
If cellular changes are detected on smear, or HPV testing detects high risk strains, a colposcopy may be recommended. Colposcopy is a test done to look closely at the cervix and detect areas that have precancerous changes.
It involves using a colposcope that allows the magnification of the image of the cervix. It may involve taking a biopsy of the affected area, and sending this sample to the laboratory for analysis.
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So how does one prepare for a Pap smear appointment?
Firstly, book it at a date when one is not having periods, or a vaginal infection. One should avoid douching, using tampons, vaginal creams or suppositories, deodorant sprays or powders, intercourse or a transvaginal scan 2 days prior to the procedure. The presence of blood, infection, trauma to or disturbance of the cervix may cause incorrect interpretation of the smear.
Secondly, list down important medical details such as your last menstrual period, previous Pap smear results and the dates when they were taken, any hormones that you are taking, and any cervical or vaginal surgery that you may have undergone.
These details will be helpful for the interpretation of the smear. Any abnormal bleeding during or after sexual contact, post-menstrual spotting, intermenstrual bleeding should also be noted and mentioned to your healthcare provider.
It cannot be over-emphasized that preventive healthcare including regular health checks is still better than cure.
Dr. Rosalyn Karlsson
Specialist Obstetrics & Gynaecology
Medcare Medical Center- JBR