Cervical Cancer: When to go for screening

Cervical Cancer originates from abnormal cells in the Cervix. It is imperative for a woman to undergo Screening at planned intervals to detect such abnormalities. Screening helps in detecting Cancer at an early stage and aids in its effective treatment. It also helps in controlling an abnormality and preventing it from converting into Cancer.

One of the primary causes of Cervical Cancer is infection of Human Papillomavirus (HPV). Cervical Screening methods include HPV Testing and Pap Test.

Necessity of Cervical Screening

Cervical Screening aids in detecting abnormal Cervical Cells, including early Cervical Cancer and Precancerous Cervical Lesions. Routine Cervical Screening helps in reducing the numbers of Cervical Cancers diagnosed and deaths occurring from this deadly disease.

Screening Tests

There are two tests for Screening of Cervical Cancer:

1. Pap Test: This test, also known as Pap Smear, detects Pre-cancers & Cancerous Cells and other abnormal cell changes in the Cervix. The procedure involves taking a sample of cells from the Cervix, and sending them to the laboratory for analysis.
2. HPV Test: This test helps in detecting DNA or RNA from high-risk HPV Types in Cervical Cells.

Screening Guidelines

One may start undergoing Cervical Screening from the age of 21 years.

The frequency of Screening depends on the woman's age and health conditions. The general guidelines for Cervical Screening are as follows:

1. Women between the age group of 21-29 years may undergo a Pap Test every three years. HPV Testing is not required for this age group. However, if Pap Tests show abnormal results, the doctor may suggest conducting a HPV Test.
2. Women between the age group of 30-65 years may undergo Co-Testing (Pap Test combined with HPV Test) every five years. Another alternative is to undergo a Pap Test every three years.
3. Women at a high risk of Cervical Cancer, due to risk factors, such as, Suppressed Immune System, exposure to DES (Diethylstilbestrol), history of Organ Transplant, and extensive use of Steroids, may require frequent Screening.
4. Annual Screening is unessential for women of all ages.
5. Even after having children, one should undergo Screening.
6. Women diagnosed with Cervical Cancer or HIV Infection should go for Screening and Diagnostic Tests prescribed by the doctor.
7. Women, who have undergone Hysterectomy, without removal of Cervix, should continue with routine Screening

Best time for Screening

Women should not undergo Cervical Screening during menstruation. The ideal time to undergo a Screening is anytime between ten to twenty days after the first day of the last menstrual period.

Preparation for Screening

To get proper results and to avoid washing or hiding of abnormal cells, women should follow the below mentioned guidelines two days before undergoing Screening:

1. Abstain from using tampons
2. Do not rinse the Vagina using water or any other fluid
3. Avoid sexual intercourse
4. Refrain from using spermicidal foam, cream, or jelly
5. Do not apply medicines or creams in the Vagina

Discontinuance of Screening

Women may opt for discontinuing of Cervical Screening in the following conditions:

1. Women over 65 years of age may discontinue Cervical Screening, subject to normal test results and other health conditions. Prior to stopping the Screening, one should take doctor's advice.
2. Women who have undergone a Total Hysterectomy (Removal of Uterus and Cervix) may discontinue Screening unless the purpose of the procedure was to treat Cervical Cancer or Cervical Pre-Cancer.
3. Women with a history of Pre-Cancers, such as CIN2 or CIN3 (Cervical Intraepithelial Neoplasia), should continue Screening for 20 years after detection of the disorder, even after the age of 65 years.
4. Women who do not have plans of bearing children should also continue with routine Cervical Screening

Screening for women who have already been vaccinated against HPV

All women, with or without a history of HPV vaccination, require routine Screening for Cervical Cancer.

Specialist

One should consult a Gynecologic Oncologist for diagnosis and treatment of Cervical Cancer

Abnormal Screening Results

If Pap tests deliver abnormal results, the doctor may suggest conducting other tests to diagnose Cancer or Pre-Cancer, such as, Colposcopy or Loop Electrosurgical Procedure. If Pap Test results are normal but HPV Tests are positive, then the doctor may either suggest a repeat of Co-Testing, or may conduct a test for HPV types 16 or 18.