Cervical Cancer Screening: Pap Smear (Cervix Test)

– The information has been reviewed by Dr. Tam Ching Ting

Pap smear, also known as Pap test, is a simple, painless cervical cancer screening procedure that only takes a few minutes. As cervical cells would undergo abnormal changes a few years before cervical cancer develops, a pap smear can help detect abnormality in the cervix in time. The test can help doctors arrange further examinations or treatments for patients earlier to prevent the development of cervical cancer.

Pap Smear Procedure
Pap Smear Procedure

A tool will be inserted into the vagina to widen the vaginal walls. Then a soft brush will be used to collect some cells from the cervix. The brush will then be put into a container that contains liquid and sent to a laboratory for testing.

When to Get a Pap Smear
When to Get a Pap Smear

As cervical cancer is closely linked to sexual lifestyle, women aged 25 and above who have ever engaged in sexual intercourse should receive regular pap testing.

Effectiveness of Pap Smear
Effectiveness of Pap Smear

The sensitivity of Pap smears is 55% to 80% while the specificity is over 90%.  Local research has shown that regular cervical screenings can help reduce the risk of cervical cancer by 90.4%, compared with those who have not been screened.

Current Statistics of Cervical Cancer
Current Statistics of Cervical Cancer

According to statistics released by the Department of Health in 2018, cervical cancer is the seventh most common cancer among women in Hong Kong, with 582 new cases recorded during the year. Cervical cancer is also the eighth major cause of female deaths in Hong Kong, accounting for 2.6% of female cancer deaths. Pap smears and cervical screenings are two effective ways to screen for cervical cancer.

 

What is cervical cancer?
What is cervical cancer?

Cervical cancer is a disease that occurs in the cells of the cervix. Infection with type 16 or 18 of human papillomavirus (HPV) is the main cause of cervical cancer. This leads to the abnormal proliferation of cervical cells, hence the development of cervical cancer. 

 

Studies have found that about 75% of the sexually active population will be infected with HPV at some point during their lifetime. Therefore, HPV vaccination is one of the effective ways to prevent HPV infection. The World Health Organization (WHO) recommends that 9-to-14-year-olds who have no sexual experience should receive HPV vaccination before they are exposed to HPV. It is because the earlier the vaccination is done, the higher the antibody level is.

Symptoms of Cervical Cancer + Risk Factors for Cervical Cancer
Symptoms of Cervical Cancer + Risk Factors for Cervical Cancer
  • Abnormal vaginal bleeding
  • Vaginal bleeding between periods
  • Heavier periods than normal
  • Bleeding after sex
  • Abnormal urination or bowel movements
  • Weight loss
  • Pelvic pain
  • Waist pain

Risk Factors for Cervical Cancer

  • Infection with HPV 16 and 18
  • Frequent sex or young age at the first sexual intercourse
  • Multiple sexual partners
  • History of STDs
  • Low immunity
  • Smoking
How is cervical cancer diagnosed?
How is cervical cancer diagnosed?

How is cervical cancer diagnosed?

Cervical cancer can be screened by Pap smear (cervical examination). However, to diagnose cervical cancer, other examinations will be performed as well.

 

Pelvic exam A device will be inserted into the vagina to widen the vaginal wall. The vagina, uterus, ovaries, fallopian tubes, bladder, and rectum will be examined to see if there is any abnormality.

Colposcopy

A colposcope, which is a special magnifying instrument, will be used to examine the cervix. The doctor will check if there is abnormal blood vessel proliferation or if there are any changes to the lesion. A sample of the tissue may be taken for further testing if necessary.

CT-Scan

If distant metastases are suspected, the patient will be arranged to undergo a computed tomography scan to have the affected location examined in detail.

Treatment for Cervical Cancer
Treatment for Cervical Cancer

 

Surgery If the patient is in the early stages of cervical cancer, surgery can be considered to remove the uterus while keeping the ovaries. As the ovaries produce hormones, this can help reduce the impact of surgery on the patient.

Radiation Therapy

Patients are recommended to undergo external or internal radiation therapy depending on their conditions.

During radiation therapy, high-energy x-rays are used to kill cancer cells. This treatment method is not painful.

Chemotherapy

This treatment is for patients with advanced cervical cancer. Anti-cancer drugs are used to stop cancer cells from reproducing and are generally given through intravenous injection.

Targeted Therapy

Drugs are used to precisely identify and attack cancer cells but not normal, healthy cells. Targeted therapy is often combined with chemotherapy and radiation therapy to treat advanced cervical cancer.

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