What is tested during a pap smear. How often should you get cervical cancer screening. What are the recommended screening methods for different age groups. What should you expect during a pap test procedure. How can you prepare for accurate test results. What do abnormal results mean.

Understanding Cervical Cancer Screening Methods

Cervical cancer screening is a crucial part of women’s health care, aimed at detecting potential issues before they develop into cancer. There are two primary screening methods used:

• HPV test: Detects the presence of human papillomavirus, which can cause cervical cell changes
• Pap test (Pap smear): Examines cervical cells for precancerous or abnormal changes

These tests can be performed separately or in combination, depending on the patient’s age and medical history. Both are typically conducted in a doctor’s office or clinic during a routine gynecological exam.

The Pap Test Procedure

During a Pap test, the healthcare provider uses an instrument called a speculum to examine the vagina and cervix. They then collect cells from the cervix and surrounding area using a small brush or spatula. These cells are sent to a laboratory for analysis.

The HPV Test Process

The HPV test utilizes the same cell collection method as the Pap test. However, instead of examining the cells for abnormalities, the laboratory tests them specifically for the presence of high-risk HPV strains that are known to cause cervical cancer.

Cervical Cancer Screening Recommendations by Age Group

Screening guidelines vary based on age and individual risk factors. Here’s a breakdown of the current recommendations:

Ages 21-29

Women in this age group should begin cervical cancer screening at age 21. The recommended method is a Pap test every three years if results are normal.

Ages 30-65

For women between 30 and 65, there are three screening options:

1. Primary HPV testing every 5 years
2. Co-testing (HPV test + Pap test) every 5 years
3. Pap test alone every 3 years

The choice between these options should be discussed with a healthcare provider to determine the most appropriate screening method based on individual risk factors and preferences.

Over 65

Women over 65 may be able to stop cervical cancer screening if they meet certain criteria:

• A history of normal screening results for several years
• No history of cervical precancer
• Cervix removal as part of a total hysterectomy for non-cancerous conditions

It’s essential to consult with a healthcare provider to determine if discontinuing screening is appropriate.

Preparing for Your Cervical Cancer Screening

Proper preparation can help ensure accurate test results. For a Pap test, consider the following guidelines:

• Avoid sexual intercourse for 2 days before the test
• Don’t use douches or vaginal medicines
• Refrain from using spermicidal foam

If you’ve had sex within two days of your appointment, inform your healthcare provider. For an HPV test, no special preparation is required.

Can you get screened during your menstrual period? Yes, both tests can still be performed during menstruation. However, it’s best to schedule your appointment when you’re not on your period to ensure the most accurate results.

Understanding Your Test Results

Receiving your test results can take up to three weeks. If the results are abnormal, your healthcare provider will contact you to discuss the next steps. It’s important to remember that abnormal results don’t necessarily indicate cancer.

Normal Results

If your test results are normal, it means your risk of developing cervical cancer in the near future is very low. Your doctor will advise you on when to schedule your next screening based on your age and the type of test performed.

Abnormal Results

Abnormal results may indicate the presence of precancerous cells. In most cases, early detection and treatment can prevent the development of cervical cancer. Your healthcare provider will guide you through any necessary follow-up procedures or treatments.

The Importance of Regular Cervical Cancer Screening

Regular cervical cancer screening is crucial for early detection and prevention. By detecting precancerous changes or the presence of high-risk HPV strains, healthcare providers can intervene before cancer develops.

How effective is cervical cancer screening? When performed regularly according to guidelines, cervical cancer screening can prevent up to 93% of cervical cancers. This high success rate underscores the importance of adhering to recommended screening schedules.

Risk Factors for Cervical Cancer

While regular screening is important for all women, certain factors can increase the risk of developing cervical cancer:

• HPV infection
• Smoking
• Weakened immune system
• Long-term use of oral contraceptives
• Multiple full-term pregnancies
• Family history of cervical cancer

Women with these risk factors may need more frequent screening or additional tests. It’s essential to discuss your individual risk profile with your healthcare provider.

Advances in Cervical Cancer Screening Technology

The field of cervical cancer screening continues to evolve, with new technologies and methods being developed to improve accuracy and patient comfort.

Liquid-Based Cytology

This newer method of preparing cervical cell samples has largely replaced the traditional Pap smear in many countries. It involves placing the collected cells in a liquid medium, which can help reduce the number of unsatisfactory samples and may detect more abnormalities.

HPV DNA Testing

Advances in HPV DNA testing have made it possible to identify specific high-risk HPV strains more accurately. This allows for more targeted follow-up and management of women at higher risk of developing cervical cancer.

Self-Sampling Methods

Research is ongoing into self-sampling methods for HPV testing, which could increase screening accessibility for women who face barriers to regular gynecological exams.

How might these advances impact cervical cancer screening in the future? As technology improves, we may see more personalized screening approaches based on individual risk factors and genetic profiles, potentially leading to more efficient and effective prevention strategies.

Addressing Common Concerns About Cervical Cancer Screening

Many women have questions or concerns about cervical cancer screening. Addressing these can help alleviate anxiety and encourage regular screening.

Pain and Discomfort

While some women may experience mild discomfort during the procedure, it is generally not painful. The exam typically takes only a few minutes, and healthcare providers are trained to make it as comfortable as possible.

Embarrassment

Feeling embarrassed is a common concern, but it’s important to remember that healthcare providers perform these exams routinely and professionally. You can request a female provider if that makes you more comfortable.

Fear of Results

Anxiety about test results is natural, but remember that early detection is key to successful treatment. Most abnormal results do not indicate cancer, and many cervical changes can be monitored or treated before they become serious.

Cost and Access

For women with low income or without health insurance, programs like the National Breast and Cervical Cancer Early Detection Program can provide free or low-cost screening tests. Check with your local health department for eligibility and available resources.

How can healthcare providers address these concerns? Open communication, patient education, and a supportive, non-judgmental approach can help women feel more comfortable with regular cervical cancer screening.

The Role of HPV Vaccination in Cervical Cancer Prevention

While not a substitute for regular screening, HPV vaccination plays a crucial role in cervical cancer prevention. The vaccine protects against the most common high-risk HPV types that cause cervical cancer.

Vaccination Recommendations

The CDC recommends HPV vaccination for:

• All children aged 11-12 years (can start at age 9)
• Everyone through age 26 if not adequately vaccinated when younger
• Some adults aged 27-45 who are not already vaccinated, based on discussion with their healthcare provider

Impact on Screening

As HPV vaccination becomes more widespread, it may impact future screening guidelines. However, even vaccinated individuals should continue to follow current screening recommendations, as the vaccine does not protect against all cancer-causing HPV types.

How effective is the HPV vaccine in preventing cervical cancer? Studies have shown that the HPV vaccine can prevent over 90% of cervical cancers caused by HPV when given before exposure to the virus. This high efficacy, combined with regular screening, offers the best protection against cervical cancer.

Empowering Women Through Education and Awareness

Knowledge is power when it comes to cervical cancer prevention. Educating women about the importance of regular screening, risk factors, and prevention strategies is crucial for reducing cervical cancer rates.

Community Outreach

Community-based education programs can help reach underserved populations and address cultural barriers to screening. These initiatives can provide information about screening options, local resources, and the importance of regular check-ups.

Patient-Provider Communication

Open and honest communication between patients and healthcare providers is essential. Providers should take time to explain screening options, address concerns, and help patients make informed decisions about their health care.

Digital Resources

Online platforms and mobile apps can provide accessible, up-to-date information about cervical cancer screening and prevention. These tools can help women track their screening schedules and understand their test results.

How can we improve cervical cancer screening rates? A multi-faceted approach that combines education, accessible screening options, and supportive healthcare environments can encourage more women to participate in regular cervical cancer screening.

By understanding the importance of cervical cancer screening, following recommended guidelines, and staying informed about advancements in prevention and detection, women can take proactive steps to protect their health. Regular screening, combined with HPV vaccination and healthy lifestyle choices, offers the best defense against cervical cancer. Remember, early detection saves lives, so don’t hesitate to discuss your cervical cancer screening needs with your healthcare provider.

What Should I Know About Cervical Cancer Screening?

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“If I didn’t go to that appointment, I might not be around for my kids,” says Cindy. Her cervical cancer screening test found precancerous cells. She shares her story in this video.

The HPV test and the Pap test can help prevent cervical cancer or find it early.

• The HPV test looks for the virus (human papillomavirus) that can cause cell changes on the cervix.
• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

Both tests can be done in a doctor’s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to look inside your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are sent to a laboratory.

• If you are getting a Pap test, the cells will be checked to see if they look normal.
• If you are getting an HPV test, the cells will be tested for HPV.

What is cervical precancer? When there are cervical cells that look abnormal but are not yet cancerous, it is called cervical precancer. These abnormal cells may be the first sign of cancer that develops years later. Cervical precancer usually doesn’t cause pain or other symptoms. It is found with a pelvic exam or a Pap test.

If you have a low income or do not have health insurance, you may be able to get a free or low-cost screening test through the National Breast and Cervical Cancer Early Detection Program.

Find out if you qualify

When to Get Screened

If You Are 21 to 29 Years Old

You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you 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—

• An HPV test only. This is called 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 called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
• 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.

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, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

No special preparation is needed before you have an HPV test.

If you are getting a Pap test, you can take steps to make sure the test results are accurate. Avoid intercourse, douching, and using vaginal medicines or spermicidal foam for 2 days before the test. If you had sex before the test, go to the appointment as planned and let the doctor know.

If you have your period, don’t worry. Both tests can still be done at this time.

Test Results

It can take as long as three weeks to receive your test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why test results might not be normal. It usually does not mean 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 important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. But you should still go to the doctor regularly for a checkup.

Pap Smear (Pap Test): Reasons, Procedure & Results

Overview

A Pap smear, also called a Pap test, is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on your cervix. The cervix is the opening of the uterus.

During the routine procedure, cells from your cervix are gently scraped away and examined for abnormal growth. The procedure is done at your doctor’s office. It may be mildly uncomfortable, but doesn’t usually cause any long-term pain.

Keep reading to learn more about who needs a Pap smear, what to expect during the procedure, how frequently you should have a Pap smear test, and more.

The American Cancer Society recommend that screening should start at age 25. Some women may be at increased risk for cancer or infection. You may need more frequent tests if:

• you’re HIV-positive
• you have a weakened immune system from chemotherapy or an organ transplant

If you’re over 25 and have not had abnormal Pap tests, ask your doctor about having one every five years if the test is combined with a human papillomavirus (HPV) screening. Current guidelines recommend that people between the ages of 25 and 65 should have an HPV test every five years.

HPV is a virus that causes warts and increases the chance of cervical cancer. HPV types 16 and 18 are the primary causes of cervical cancer. If you have HPV, you may be at an increased risk of developing cervical cancer.

Women over the age of 65 with a history of normal Pap smear results may be able to stop having the test in the future.

You should still get regular Pap smears based on your age, regardless of your sexual activity status. That’s because the HPV virus can be dormant for years and then suddenly become active.

How often you need a Pap smear is determined by various factors, including your age and risk.

These recommendations only apply to women who have a cervix. Women who have had a hysterectomy with removal of the cervix and no history of cervical cancer do not need screening.

Recommendations vary and should be individualized for women with compromised immune systems or a history of precancerous, or cancerous lesions.

You can schedule a Pap smear with your annual gynecological examination or request a separate appointment with your gynecologist. Pap smears are covered by most insurance plans, though you may be required to pay a co-pay.

If you’ll be menstruating on the day of your Pap smear, your doctor may want to reschedule the test, since results could be less accurate.

Try to avoid having sexual intercourse, douching, or using spermicidal products the day before your test because these may interfere with your results.

In most cases, it’s safe to have a Pap smear in the first 24 weeks of a pregnancy. After that, the test may be more painful. You should also wait until 12 weeks after giving birth to increase the accuracy of your results.

Since Pap smears go more smoothly if your body is relaxed, it’s important to stay calm and take deep breaths during the procedure.

Pap smears can be a bit uncomfortable, but the test is very quick.

During the procedure, you’ll lie on your back on an examination table with your legs spread and your feet resting in supports called stirrups.

Your doctor will slowly insert a device called a speculum into your vagina. This device keeps the vaginal walls open and provides access to the cervix.

Your doctor will scrape a small sample of cells from your cervix. There are a few ways your doctor can take this sample:

• Some use a tool called a spatula.
• Some use a spatula and a brush.
• Others use a device called a cytobrush, which is a combination spatula and brush.

Most women feel a slight push and irritation during the brief scraping.

The sample of cells from your cervix will be preserved and sent to a lab to be tested for the presence of abnormal cells.

After the test, you might feel mild discomfort from the scraping or a bit of cramping. You could also experience very light vaginal bleeding immediately following the test. Tell your doctor if discomfort or bleeding continues after the day of the test.

There are two possible results from a Pap smear: normal or abnormal.

Normal Pap smear

If your results are normal, that means that no abnormal cells were identified. Normal results are sometimes also referred to as negative. If your results are normal, you probably won’t need a Pap smear for another three years.

Abnormal Pap smear

If the test results are abnormal, this doesn’t mean you have cancer. It simply means that there are abnormal cells on your cervix, some of which could be precancerous. There are several levels of abnormal cells:

• atypia
• mild
• moderate
• severe dysplasia
• carcinoma in situ

Milder abnormal cells are more common than severe abnormalities.

Depending on what the test results show, your doctor may recommend:

• increasing the frequency of your Pap smears
• · getting a closer look at your cervical tissue with a procedure called colposcopy

During a colposcopy exam, your doctor will use light and magnification to see vaginal and cervical tissues more clearly. In some cases, they may also take a sample of your cervical tissue in a procedure called a biopsy.

How accurate are the results?

Pap tests are very accurate. Regular Pap screenings reduce cervical cancer rates and mortality by at least 80 percent. It can be uncomfortable, but the brief discomfort can help protect your health.

The main purpose of a Pap smear test is to identify cellular changes in the cervix, which could be caused by HPV.

By detecting cervical cancer cells early with a Pap smear, treatment can start before it spreads and becomes a bigger concern. It’s also possible to test for HPV from the Pap smear specimen, too.

You can contract HPV from having sex with men or women. To lower your risk of contracting the virus, practice sex with a condom or other barrier method. All sexually active women are at risk for contracting HPV and should get a Pap smear at least every three years.

The test doesn’t detect other sexually transmitted infections (STIs). It can occasionally detect cell growth that indicates other cancers, but it shouldn’t be relied on for that purpose.

Smear for cytology of the cervix – cost and detailed explanation at the Lancet clinic

Smear for oncocytology

Oncocytology smear cervix – a basic cytological examination of cells in mucosal tissues taken from the surface of the vagina and cervical canal (the junction of the vagina and uterus), which reveals the presence of precancerous or cancerous changes.

The term of the study is 3-4 days from the moment of biomaterial sampling.

This test is usually given as a preventative measure and not to confirm a suspected disease.

• When is it recommended to take a smear
• The nuances of preparing for the procedure
• Analysis analysis
• How treatment is carried out
• Where is the best place to take a smear?

Initial appointment

2 500 ₽

Repeated appointment

1 300 ₽

All prices

When women It is not recommended to take a smear for cytology

• As part of gynecological screening

• If erosion is detected , dysplasia, HPV or warts

• If there is a hereditary predisposition to cervical cancer

• After an organ transplant

• After prolonged use of steroids or oral contraception

• When HIV, chlamydial infections or herpes are detected tracking result

cells or any suspicious changes, the doctor prescribes an additional analysis – liquid cytology, which allows you to more accurately confirm or refute the diagnosis.

Nuances of preparation for the procedure

Any inflammatory process in the vagina and uterus can affect the correctness of the test result, so it is carried out only after the inflammation has been removed.

Two days before taking a scraping, do not:

• douche;
• take a hot bath;
• visit the swimming pool and sauna;
• have sexual intercourse;
• take drugs intravaginally.

It is better to take material for cytology in the middle of the cycle – starting from 6-7 days, but later than 5 days before the onset of menstruation.

If the patient is scheduled for a colposcopy at the same time, then the analysis is taken either before the procedure or two days after it.

How the analysis is carried out

Material sampling

Biomaterial is taken during examination in the gynecological chair. The gynecologist, using mirrors and a special probe-brush, takes several smears from the mucous membrane of the vagina, cervical canal and cervix.

Material transfer

The resulting material is transferred from the probe to the glass slide, fixed with an alcohol composition and dried. The glass is placed in a labeled sealed bag and transferred to the laboratory.

Examination

In the laboratory, the biomaterial is examined under a microscope and tested by staining with various reagents (Papanicolaou test), which make it possible to see the altered cells.

Analysis transcript

The results of a smear for cytology are provided according to the unified (approved worldwide) Bethesda system and allow you to state the presence or absence of atypical cells in the resulting smear:

• NILM – normal

• ASC (ASC-US, ASC-H) – reactive changes indicating the presence of inflammation

• LSIL – initial stage of dysplasia 9002 5

• HSIL – moderate or severe dysplasia

• Density of intercellular products decreases (mucus, blood cells, membranes of destroyed cells, etc. ), which are not needed for research

• CIS – carcinoma, malignant formation0003

Any result is not a cause for panic. If you were assigned a classic smear for oncocytology, most likely, dysplasia was not detected during the examination. This suggests that the changes did not affect a large number of cells, and with proper and timely treatment, you will cope with the disease. In order not to worry longer than necessary, come to the Lancet for accurate diagnosis and treatment according to advanced protocols.

How are abnormal cells treated

The choice of treatment method depends on which abnormalities the test shows.

• When an inflammatory process is detected, anti-inflammatory drugs are prescribed to help eliminate the pathological process and prevent possible complications. After stabilization of the state, the analysis is repeated.

• If mild dysplasia is detected, the patient is registered and her condition is monitored in order to prevent the development of an oncological process.

• Subsequent stages of dysplasia require additional studies, based on the results of which treatment or enhanced control is prescribed.

• If the analysis revealed oncology, a second test is performed, followed by a series of examinations and analyses. After collecting anamnesis, treatment is prescribed – surgery, chemotherapy, targeted therapy – what suits the patient in her case.

Where is the best place to take a smear for oncocytology?

The quality of material sampling directly affects the test result. In 70% of cases, the doctor who did the scraping poorly is to blame for obtaining a false negative result.

In order to eliminate a mistake on our part, we have taken a number of measures:

• The sampling is carried out by a specialized oncogynecologist with 12 years of experience

• The procedure is performed exactly according to the protocol – this moment is controlled by internal standards clinics

• Probes are used that provide high-quality sampling of material due to the innovative shape of the brush

When you take a smear for oncocytology at the Lancet outpatient surgery center, you can be sure that the laboratory will receive the most informative material, and you – exact result.