Articles
Above 30? Do a Pap smear test for your safety
3/6/2009
CERVICAL CANCER SCREENING
By Dr. Chandrakala Sarda
MBBS, MD(Obstetrics and Gynaecology)
Specialist Gynaecologist and Obstetrician, Woman Care Clinic at Dr. Sunny Medical Centre, Shahba, Sharjah
CERVICAL CANCER –Cervical Cancer is the cancer of mouth or /neck of the womb.
Cervical cancer is the second most common cause of female cancer related deaths worldwide. Each year, over 5000 women die of cervical cancer in America. In India, 30% of the cancers reported in women are the cancer of the womb. Cervical cancer is nearly 100% preventable.
In developed countries, more than 75% of cervical cancer is present in early stage, thanks to Cervical screening by cervical smear (Pap smear. At this stage, cervical cancer can be cured completely. On the contrary, in underdeveloped countries, 75% of cervical cancer cases present with advanced stage of the disease, and overall half of the females with cervical cancer die within 5 years.
Invasive disease is preceded by cervical intra-epithelia neoplasia (CIN), effective treatment of CIN prevents progression. Woman at risk of having CIN can be identified by exfoliative cytology. This we call as cervical screening or Pap’s Smear. Pap’s smear is screening by cervical cytology, where a sample of cells is taken from the cervix for analysis.
This is done during gynecological examination. Pelvic examination is performed using speculum. With a suitable 360° spatular sweep around the cervix at external cervical opening, cells are collected and smeared on a glass slide and fixed immediately. These slides are stained and examined under microscope by a pathologist for any abnormalities and infections.
Mean age for pre - cancerous condition, called CIN is 30 years. In sexually active women, it is advised to have Pap smear every year. If there is a problem, then the doctor will advise you to have it earlier. If patient cannot afford this and the report is normal, then it can be postponed to 3 years.
The American cancer society recommend that screening stops at age 70, if three or more recent tests are normal, and there have been no abnormal results in the last 10 years. In England & Wales, it is done minimum up to 65 years.
We may wonder what causes cervical cancer, exact cause is uncertain, but research has shown there are following risk factors that predisposes to cervical cancer.
(1) Infection with the Human Papilloma Virus (HPV), subtypes 16 and 18, 31 and 33 have been confirmed as agents which cause cervical cancer. High risk HPV types have been found to be present in close to 100% of all cervical cancers presenting.
(2) Smoking.
(3) Sexual intercourse at early age.
(4) Multiple partners.
(5) Compromised immune status.
Most common presenting features of cervical cancer are
• Foul smelling discharge.
• Post- coital bleeding or inter- menstrual bleed or discharge.
Foul smelling discharge may be the initial symptom. Other symptoms like Anemia may result from heavy vaginal bleeding. :
• Pelvic and leg pain is uncommon in early tumors but often occurs in later stages of the disease.
• Feeling of pelvic discomfort or pressure in the lower abdomen.
• Frequently urge to visiting toilet and blood in urine.
• Tenesmus or Rectal bleeding.
So message to remember is having annual gynaecological examination with Pap smear, do not smoke, practice safe sex and spread awareness of Cancer screening.
There are many reasons apart from financial one to postpone having Pap smear. So how can we help them?
We can help our friend by reassuring her that Pap smear test doesn’t hurt.
You can give her a ride to go to the clinic or offer help with child care.
Good news is that a vaccine for cervical cancer has been developed and will soon be available in the market.
Our main aim should be to prevent cervical cancer, in case of occurrence, defeat it early in pro-invasive stage and treat it so that nobody will die of this disease.
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