What is tested during a Pap smear. How often should you get cervical cancer screening. What are the differences between Pap tests and HPV tests. How to prepare for cervical cancer screening. What do abnormal results mean.

The Importance of Cervical Cancer Screening

Cervical cancer screening is a crucial preventive measure that can detect early signs of cancer or precancerous conditions. Regular screening has significantly reduced cervical cancer rates worldwide. The two primary methods used for cervical cancer screening are the Pap test (or Pap smear) and the HPV test.

What is a Pap Smear?

A Pap smear is a procedure that collects cells from the cervix to check for abnormalities that could lead to cervical cancer. During the test, a healthcare provider uses a speculum to examine the vagina and cervix, then gently scrapes cells from the cervix for laboratory analysis.

What is an HPV Test?

The HPV test looks for the presence of human papillomavirus, which is the primary cause of cervical cancer. This test can be performed using the same cell sample collected during a Pap smear or as a standalone test.

Who Should Get Cervical Cancer Screening?

Cervical cancer screening recommendations vary based on age and risk factors. Here are the general guidelines:

• Ages 21-29: Pap test every 3 years
• Ages 30-65: HPV test every 5 years, or co-testing (Pap test + HPV test) every 5 years, or Pap test every 3 years
• Over 65: Screening may be discontinued if previous results have been consistently normal

Women with certain risk factors may need more frequent screening. It’s essential to consult with your healthcare provider to determine the best screening schedule for you.

The Cervical Cancer Screening Procedure

The procedure for both Pap smears and HPV tests is similar and relatively quick, usually taking only a few minutes.

1. You’ll lie on an exam table with your feet in stirrups
2. The healthcare provider will insert a speculum into your vagina to open it
3. They will then use a small brush or spatula to collect cells from your cervix
4. The sample is sent to a laboratory for analysis

While the procedure may cause slight discomfort, it shouldn’t be painful. If you experience pain, inform your healthcare provider immediately.

Preparing for Your Cervical Cancer Screening

To ensure accurate results from your Pap smear or HPV test, follow these guidelines:

• Avoid sexual intercourse for 2 days before the test
• Don’t use douches, tampons, or vaginal medicines for 2 days before the test
• Try to schedule your appointment when you’re not menstruating
• If you’re menstruating and can’t reschedule, inform your healthcare provider

It’s important to note that HPV tests don’t require any special preparation.

Understanding Your Cervical Cancer Screening Results

Receiving your test results can take up to three weeks. The outcomes can be categorized as follows:

Normal Results

If your results are normal, it means no abnormal cells were detected. Your healthcare provider will advise when you should return for your next screening based on your age and risk factors.

Abnormal Results

Abnormal results don’t necessarily mean you have cancer. They indicate the presence of cell changes that require further investigation. Your healthcare provider will recommend additional tests or procedures to determine the cause of the abnormal results.

The Role of HPV in Cervical Cancer

Human Papillomavirus (HPV) is the primary cause of cervical cancer. There are over 100 types of HPV, but only a few high-risk types are associated with cervical cancer. Understanding the link between HPV and cervical cancer is crucial for prevention and early detection.

How Does HPV Cause Cervical Cancer?

HPV infects the cells of the cervix, and in some cases, it can cause these cells to become abnormal or precancerous. Over time, if left untreated, these abnormal cells may develop into cervical cancer. However, it’s important to note that most HPV infections clear on their own without causing any harm.

HPV Vaccination

HPV vaccination is a powerful tool in preventing cervical cancer. The vaccine protects against the most common high-risk HPV types. It’s recommended for both girls and boys, ideally before they become sexually active.

Beyond Screening: Preventing Cervical Cancer

While regular screening is crucial, there are additional steps you can take to reduce your risk of cervical cancer:

• Get vaccinated against HPV
• Practice safe sex to reduce the risk of HPV infection
• Don’t smoke, as smoking increases the risk of cervical cancer
• Maintain a healthy diet rich in fruits and vegetables
• Boost your immune system through regular exercise and stress management

Remember, cervical cancer is highly preventable with regular screening and appropriate follow-up care.

Advanced Screening Technologies and Future Developments

The field of cervical cancer screening is continuously evolving, with new technologies and approaches being developed to improve accuracy and accessibility.

Liquid-Based Cytology

This technique improves the quality of cell samples, potentially reducing the number of unsatisfactory results and the need for repeat testing.

Computer-Assisted Screening

Artificial intelligence is being used to analyze Pap smear results, potentially increasing accuracy and efficiency in detecting abnormal cells.

Self-Sampling for HPV

Research is ongoing into self-sampling methods for HPV testing, which could increase screening rates by making the process more convenient and accessible.

Biomarker Testing

Scientists are investigating various biomarkers that could help identify women at higher risk of developing cervical cancer, allowing for more personalized screening approaches.

Addressing Common Concerns and Misconceptions

Despite the importance of cervical cancer screening, many women have concerns or misconceptions that may prevent them from getting tested regularly.

Is Cervical Cancer Screening Painful?

While some women may experience slight discomfort during the procedure, it shouldn’t be painful. If you’re anxious, communicate with your healthcare provider, who can take steps to make you more comfortable.

Can I Get Screened If I’m Pregnant?

Yes, Pap smears are generally safe during pregnancy. However, HPV testing is typically avoided. Always inform your healthcare provider if you’re pregnant or think you might be.

Do I Need Screening If I’ve Had the HPV Vaccine?

Yes, even if you’ve been vaccinated against HPV, you should still follow regular screening guidelines. The vaccine doesn’t protect against all types of HPV that can cause cervical cancer.

What If I Can’t Afford Screening?

Many countries offer free or low-cost cervical cancer screening programs. In the United States, the National Breast and Cervical Cancer Early Detection Program provides screening services to eligible women.

By addressing these concerns and promoting awareness, we can encourage more women to participate in regular cervical cancer screening, ultimately reducing the incidence and mortality of this preventable disease.

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.