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Every woman should get it done,pap test

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Every woman should get it done

pap test

Introduction:

Now a days cancers are one of the most common disease prevalent around us. With all the negativity they carry with their name, still there is hope of life and treatment associated with some of them. One of such tumors are cervical cancers which can be detected at very early stage and hence treated successfully. Cervix is lower part of uterus situated above the vagina and connects it to uterus. Cervical cancer is abnormal growth of cells that can involve surrounding structures and even metastasize to other organs.

Cervical cancer was one of the most common and fatal female tumors before 1930. In 20th century a drastic decrease was observed in this cancer attributing to a test done for it named as Pap test or Pap smear. Now these cancers are not even ranked in top ten common tumors.

History

 Pap (Papanicolaou) test done for cervical cancer is considered to be most effective cancer reduction program known till now. Credit of conception of this goes to George N. Papanicolaou, an anatomist, dating back to 1928. He reported that malignant cells from the cervix can be identified in vaginal smears. He also published detailed descriptions of the pre-malignant  lesions.

 Later several studies led to improvements in the results, descriptions and techniques. Eventually cytological smears were welcomed as ideal screening tests for even initial preinvasive lesions, which if treated timely, would be prevented from developing into full blown cancer. In 1940, first cervical screening clinics were established and it was noted that there was direct correlation between intensity of screening and decrease in mortality.

Who and when to get this test

This test should be done at the age of 21years. Before this even if the female is sexually active there is no recommendation for undergoing this test. The women between 21 to 29 years should get it done every 3 years. Women aged 30 to 65 should have pap test alone every 3 years, or cotesting of cytology with human papillomavirus every 5 years.

HPV testing and vaccine:

Human papillomavirus is the virus which is one of the causes of cervical cancer and it is sexually transmitted. It is divided into high risk and low risk HPV. The high risk HPV are more commonly associated with the cervical cancer and include type 16,18,31, 33 and few others. The low risk HPV include 6 and 11 which can cause genital lesions but very rarely cause cancer.

Due to the association of HPV with cervical cancer, two HPV prophylactic vaccine are developed and now available that have opened new horizons in prevention of cervical cancer. Both of these vaccines contain virus-like particles that are actually empty protein shells. One of the vaccine protects against HPV 6,11,16 and 18. The other one is bivalent that protects against HPV 16 and 18. The vaccines are administered in three doses prior to initiation of sexual activity.

Age to get vaccinated

The American cancer society recommends at the ages of 11 and 12 years but females aged 13 to 18 can be vaccinated who missed the opportunity of getting vaccinated. Even after the vaccinations are done, still pap test has to be done because these vaccines do not protect against 30% cancers and duration of protection is not known.

     At the age of 65 years if there was adequate prior screening done and no history of cervical intra-epithelial lesion 2 or higher was present then screening should be discontinued. In the cases of total hysterectomy with no history of cervical intraepithelial lesion 2 or higher then screening is not recommended.

Consulting doctor for pap test:

if a female wants a pap test to be done then she should visit at least 5 days after menstrual period and not  during it. Tampoons , birth control jells, vaginal creams and coitus should not be done at least two to three days before the procedure is to be done.

Results of pap test:

If the result is negative then nothing to worry about. If the test is positive it does not necessarily mean that you have cancer. Atypical cells can be seen in infections, intra-uterine device, non-specific inflammation, pre-invasive lesions and invasive cancer. The doctor will recommend the treatment according to the cause of atypical cells.

 If there is inflammation and infection this will be treated with antimicrobial agents. In case of some atypical cells that raise the suspicion of cancer or are clearly cancerous the doctor will suggest colposcopic examination. This allows the close view of the cervix and gives the clarity regarding the lesion.

Depending on its findings and results of histopathological examination of cervical biopsy further management is decided. May be just a close follow-up may be the requirement. However, even if cervical cancer is diagnosed it can be successfully treated especially if it is in early stages giving an excellent survival rate. Therefore all the eligible  women should undergo this simple test and prevent themselves from a malignancy and hazardous effects of that.

 

Dr Saadia Hafeez

 

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