Cervical Cancer

What Is Cervical Cancer?

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body.

Cervical cancer starts in the cells lining the cervix — the lower part of the uterus (womb). The cervix connects the body of the uterus to the vagina .

Cervical Cancer- Dr Rachna Singh

Most cervical cancers begin in the cells in the transformation zone. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer. It usually takes several years  but it also can happen in less than a year.

 For most women, pre-cancerous cells will go away without any treatment. Still, in some women pre-cancers turn into true (invasive) cancers. Treating all cervical pre-cancers can prevent almost all cervical cancers.

 Several terms are used to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN)squamous intraepithelial lesion (SIL), and dysplasia.

CERVICAL CANCER SCREENING

PAP’S SMEAR

Pap’s Smear is not just the pelvic examination.

The Pap test is a procedure used to collect cells from the cervix so that they can be looked at under the microscope to find cancer and pre-cancer.

The doctor uses a small brush or spatula to gently remove cells from the cervix by superficial scrapping and sends them to lab.

The procedure is painless and does not require any insicions or pricks .

You may need some basic preparation before you arrive at doctors office .You can discuss that with your Doctor at pre-appointment.

 WHO SHOULD DO IT

That depends on your age, your medical history, and your risks.

  • Ages 21 to 30: You should have a Pap test every three years. Cervical cancer takes 10 to 20 years to develop, so you don’t need the test each year. You do not need a Pap test before age 21, even if you are sexually active.
  • Ages 30 to 65: The new guidelines from the American Cancer Society  say that you can have the Pap test every five years—as long as you have a test for the human papillomavirus, or HPV, at the same time.
  • Age 65 or older: You do not need Pap tests if your recent ones have been normal.
  • If you have risk factors for cervical cancer, ask your doctor how often you need a Pap test.
  • Risk factors include: pre-cancer cells in your cervix, a history of cervical cancer, or a weak immune system.

The HPV DNA Test

The most important risk factor for developing cervical cancer is infection with HPV. Doctors can now test for the HPV (high-risk or carcinogenic types) that are most likely to cause cervical cancer .

The HPV DNA test is most often used in 2 situations:

  • The HPV gene test can be used in combination with the Pap test to screen for cervical cancer. The American Cancer Society recommends this combination for women 30 and older. The HPV DNA test is not recommended to screen for cervical cancer in women under 30.
  • The HPV DNA test can also be used in women who have slightly abnormal Pap test results (ASC-US) to find out if they might need more testing or treatment..

An HPV DNA test has been approved by the FDA to be used without a Pap test to screen for cervical cancer.  

Follow-up of HPV testing

If your Pap test result is normal, but you test positive for HPV, the main options are:

  • Repeat co-testing (with a Pap test and an HPV test) in one year
  • Testing for HPV types 16 or 18 (this can often be done on the sample in the lab).
  •  If the test is positive for types 16 or 18, colposcopy would be recommended If you test negative, you should get repeat co-testing in one year.

COLPOSCOPY

Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope. It shines a light into the vagina and onto the cervix. With help of lens and a bright light , your doctor  gets to have  a better look at your cervix. A colposcope  greatly enlarges the normal view. This exam allows the health care provider to find problems that cannot be seen by the eyes.

Your doctor will  also swab your cervix with certain chemicals . It’ll highlight any suspicious-looking areas.

If need be, then the biopsy is taken from suspicious areas and send to lab for reporting .

CERVICAL CANCER PREVENTION

The first way is to find and treat pre-cancers before they become true cancers, and the second is to prevent the pre-cancers.

HPV is passed from one person to another during skin-to-skin contact with an infected area of the body

Also, HPV infection seems to be able to be spread from one part of the body to another. This means that an infection may start in the cervix and then spread to the vagina and vulva.

Use condoms

Condoms (“rubbers”) provide some protection against HPV but they don’t completely prevent infection, also help protect against HIV and some other sexually transmitted infections. 

Don’t smoke

Not smoking is another important way to reduce the risk of cervical pre-cancer and cancer.

Get vaccinated

Vaccines are available that can protect young people against certain HPV infections. These vaccines protect against infection with the HPV subtypes most commonly linked to cancer, as well as some types that can cause anal and genital warts.

These vaccines only work to prevent HPV infection − they will not treat an infection that is already there. That is why, to be most effective, the HPV vaccines should be given before a person becomes exposed to HPV (such as through sexual activity).

The vaccines require a series of injections (shots). Side effects are usually mild. The most common one is short-term redness, swelling, and soreness at the injection site. Rarely, a young person will faint shortly after the vaccine injection.

The American Cancer Society recommendations for HPV vaccine use are similar to those from the federal Advisory Committee on Immunization Practices (ACIP), and include the following:

  • Routine HPV vaccination for girls and boys should be started at age 11 or 12. The vaccination series can be started as early as age 9.
  • HPV vaccination is also recommended for females 13 to 26 years old and for males 13 to 21 years old who have not started the vaccines, or who have started but not completed the series. Males 22 to 26 years old may also be vaccinated.*
  • HPV vaccination is also recommended through age 26 for men who have sex with men and for people with weakened immune systems (including people with HIV infection), if they have not previously been vaccinated.

*For people 22 to 26 years old who have not started the vaccines, or who have started but not completed the series, it’s important to know that vaccination at older ages is less effective in lowering cancer risk.

It’s important to realize that no vaccine provides complete protection against all cancer-causing types of HPV, so routine cervical cancer screening is still necessary.

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