Regular screenings can aid in the early detection of cervical cancer. The HPV test and the Pap test are the procedures for cervical cancer screening. These tests can happen alone or simultaneously (called a co-test). We can prevent cervical cancer by regular screening. The most important thing to remember is to get the screening regularly, regardless of your test.
What is cervical cancer?
When malignant (cancer) cells form in the cervix, it is cervical cancer. The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal). Screening for cervical cancer using the Pap test has decreased the number of new cases of cervical cancer and the number of deaths due to cervical cancer since 1950. Human papillomavirus (HPV) infection is the major risk factor for cervical cancer.
What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. It is easier to treat when you find abnormal tissue or cancer early. By the time symptoms appear, cancer may have begun to spread.
Scientists are trying to understand better which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screening for cancer, what the tests are, and how often the tests should happen.
Why is screening important?
It is important to remember that your doctor does not necessarily think you have cancer if they suggest a screening test. Doctors give you screening tests when you have no cancer symptoms. If a screening test result is abnormal, you may need more tests to determine if you have cancer. These are diagnostic tests.
Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which cells that are not normal begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and surrounding areas.
Cervical dysplasia occurs more often in women in their 20s and 30s. Death from cervical cancer is rare in women younger than 30 years and women of any age who have regular screenings with the Pap test. The Pap test detects cancer and changes that may lead to cancer. The chance of death from cervical cancer increases with age. In recent years, deaths from cervical cancer have been slightly higher in Black women younger than 50 years than in White women younger than 50 years. Deaths from cervical cancer are almost twice as likely in Black women older than 60 years than in White women aged than 60 years.
Other risk factors for cervical cancer include:
- Giving birth to many children.
- Smoking cigarettes.
- Using oral contraceptive pill.
- Having a weakened immune system.
How is the Pap test done?
The doctor first places a speculum inside the vagina. The speculum is a metal or plastic instrument that keeps the vagina open so the cervix can be seen clearly. Next, using a small spatula or brush, a sample of cells and mucus is lightly scraped from the exocervix. A small brush or a cotton-tipped swab is then inserted into the opening of the cervix to take a sample from the endocervix . If your cervix has been removed (because you had a trachelectomy or hysterectomy) as a part of cervical cancer or pre-cancer treatment, the cells from the upper part of the vagina (known as the vaginal cuff) will be sampled. The samples are then looked at in the lab.
Although the Pap test has been more successful than any other screening test in preventing cancer, it’s not perfect. One of the limitations of the Pap test is that the results need to be examined by the human eye, so an accurate analysis of the hundreds of thousands of cells in each sample is not always possible. Engineers, scientists, and doctors are working together to improve this test. Because some abnormalities may be missed (even when samples are looked at in the best labs), it’s best to have this test regularly.
How can you make your Pap tests more accurate?
You can do several things to make your Pap test as accurate as possible:
- Try not to schedule an appointment for a time during your menstrual period. The best time is at least 5 days after your period stops.
- Don’t use tampons, birth-control foams or jellies, other vaginal creams, moisturizers, lubricants, or vaginal medicines for 2 to 3 days before the Pap test.
- Do not douche for 2 to 3 days before the Pap test.
- Don’t have vaginal sex for 2 days before the Pap test.
How is the HPV test done?
The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.
It is done in a doctor’s office or clinic. Doctors can test for the high-risk HPV types most likely to cause cervical cancer by looking for pieces of their DNA in cervical cells.
Human papillomavirus (HPV) infection is the major risk factor for cervical cancer. Although most women with cervical cancer have the human papillomavirus (HPV) infection, not all women with an HPV infection will develop cervical cancer. Many different types of HPV can affect the cervix; only some cause abnormal cells that may become cancer. Some HPV infections go away without treatment. HPV infections are spread mainly through sexual contact. Women who become sexually active at a young age and have many sexual partners are at increased risk for HPV infections.
When to get screened:
If you are between 21 to 29 years old. You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may suggest that you can wait three years until your next Pap test.
If you are 30 to 65 years old. Talk to your doctor about which testing option is right for you—
A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test. This is primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test. An HPV test along with the Pap test. This is co-testing. If both results are normal, your doctor may tell you that you can wait five years until your next screening test.
If you are older than 65. Your doctor may tell you that you don’t need to be screened anymore if—You have had normal screening test results for several years or if your cervix was removed as part of a total hysterectomy for non-cancerous conditions like fibroids.
How to prepare for your pap or HPV test
You should not schedule your test for a time when you are having your period. If you are going to have a test in the next two days—
- You should not douche (rinse the vagina with water or another fluid).
- You should not use a tampon.
- Don’t have sex.
- You should not use birth control foam, cream, or jelly.
- You should not use medicine or cream in your vagina.
It may get your test reports after three weeks. Your doctor will contact you and figure out how best to follow up. There are numerous causes for abnormal test findings. Typically, it doesn’t imply that you have cancer.
If your test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is essential to follow up with your doctor right away to learn more about your test results and receive any medicine that may be needed.
If your test results are normal, your chance of getting cervical cancer in the next few years is very minimal. Your doctor may suggest you that you can wait several years for your next cervical cancer screening test. But you should still regularly go to the doctor for a checkup.
Early detection increases the probability that a patient will respond well to treatment and can stop any early mutations in a woman’s cervical cells from progressing to cancer. Keeping an eye out for any cervical cancer symptoms and signs can also aid in preventing unnecessary delays in diagnosis.