According to a recent news (Oct 17,2011) published by Medscape.com “Screening for cervical cancer is equally effective with conventional Pap testing and liquid-based cytology with human papillomavirus (HPV) testing.”
The second review focused on the ages at which to appropriately begin and end cervical cancer screening. Lead author Kimberly K. Vesco, MD, MPH, and colleagues presented a “narrative review” of risk factors and other epidemiologic considerations. According to Vesco “the evidence suggests that the potential harms of screening outweigh the benefit of cervical cancer screening for women under 20.” Dr. Vesco said that the data support discontinuing screening for women 65 years and older without a history of CIN or cervical cancer who have had recent negative cervical cancer screening.
Cervical cancer is a slow growing cancer caused by certain strains of the human papillomavirus (HPV), an extremely common sexually transmitted disease among women and men. HPV also causes genital and anal warts, as well as oral and anal cancer. The best way to detect cervical cancer is by having regular Papanicolaou tests, or Pap smears. (Pap is a shortened version of the name of the doctor who developed the screening test.) A Pap smear is a microscopic examination of cells taken from the cervix.
American Council of Obstetric & Gynecology revised recommendations are:
- Women from ages 21 to 30 be screened every two years instead of annually, using either the standard Pap or liquid-based cytology.
- Women age 30 and older who have had three consecutive negative cervical cytology test results may be screened once every three years with either the Pap or liquid-based cytology.
- Women with certain risk factors may need more frequent screening, including those who have HIV, are immuno-suppressed, were exposed to diethylstilbestrol (DES) in utero, and have been treated for cervical intraepithelial neoplasia (CIN) 2, CIN 3, or cervical cancer.
A Pap smear test is reasonable after every three years, according to the United States Preventive Services Task Force, sided by American Cancer Society. “If you test every year you find a lot of benign infections that would go away on their own,” said Philip Castle of the American Society for Clinical Pathology. “You end up over-screening, over-managing and over-treating women who are not actually at risk of getting cervical cancer.”
What is Involved?
The best time to get a Pap smear is 10 to 20 days after the first day of your last period. If menstruating on the day of the test please reschedule.
A Pap smear is performed by a specialist in a few minutes. Lie down on your back on an exam table with your knees bent, heels resting in supports called stirrups. Your doctor will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of the vagina apart so that your doctor can easily see your cervix. Inserting the speculum may cause a sensation of pressure in your pelvic area. Then your doctor takes samples of your cervical cells using a soft brush or a flat scraping device called a spatula. This usually doesn’t hurt.
The sample of cells is evenly applied to a glass slide and sprayed with a fixative. This sample is sent to the lab for close and careful examination under a microscope. If the doctor is using a new kind of Pap smear called a ThinPrep test, the sample is rinsed into a vial and sent to a lab for slide preparation and examination.
After the Pap smear is performed, the cervix is washed with a diluted vinegar solution and examined for abnormalities using a light and a magnifying device (a colposcope). If abnormal areas are detected, further evaluation is necessary, regardless of the results of the Pap smear.
What the Results Mean?
If only normal cervical cells were discovered during your Pap smear, you’re said to have a negative result. You won’t need any further treatment or testing until you’re due for your next Pap smear and pelvic exam.
If abnormal or unusual cells were discovered during your Pap smear, you’re said to have a positive result. A positive result doesn’t mean you have cervical cancer. It means, further testing is needed to determine the source of the abnormal cells and their significance. You might have to undergo a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. The specialist may take a tissue sample (biopsy) from any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis