Screening for Cervical Cancer

Cervical cancer is ​​one of the few cancers that can be diagnosed early, that is, before any symptoms are experienced. The vast majority of cervical cancers develop from pre-malignant cell changes, so there are two ways to avoid this illness: first, by preventing pre-malignant lesions and on the other hand, detect and treat before these lesions progress.

It is important that you should ask your gynecologist about the best way to reduce the risk of infection with human papillomavirus.

Detection of premalignant lesions

The routine gynecological check-ups and regular realization of  Pap test or cervical-vaginal cytology allows the diagnosis of pre-malignant lesions, so that their treatment avoids they progress to invasive lesions.

The Pap test or Pap smear remains the most suitable and used for the diagnosis of precursor lesions of cervical cancer, compared with other tests currently available. The implementation of screening programs conducted effectively, has shown it to be effective in reducing the incidence and mortality of cervical cancer worldwide, although none has managed to totally eradicate the disease.

The Pap test is a simple, painless test performed during routine gynecological exam. Using a spatula, cells back of the vagina and the ectocervix are obtained. The cells thus collected are deposited on a special glass, which will be sent to the laboratory to analyze the sample under a microscope.

To prevent the maximum number of errors, it is important for women to follow a series of recommendations before going to the gynecologist to perform this test:

  • Avoid sexual intercourse within 48 hours prior to the test.
  • Avoid douching in the previous 48 hours.
  • No use of spermicide or other vaginal creams 48 hours before the test.

The test has to be made between periods.

Performing this test in women who are or have been sexually active, have not undergone hysterectomy, aged between 25 and 65 years is recommended. The upper age limit depends on whether the last two smears are normal.

The test should be performed at intervals of three years.

Classification of pre-malignant lesions

The most widely used system for describing pre-malignant lesions is the Bethesda system which was last revised in 2001. The general categories are:

  • Negative for intraepithelial lesion or malignancy. No signs of cancer or precursor lesions are observed.
  • Abnormal epithelial cells: abnormal cells are seen although the cause can not be identified (infection, inflammation or cancer). In these cases it would be necessary to repeat the test a few months later.
  • Squamous intraepithelial lesion: refers to premalignant lesions. They are divided into low-grade lesions and high-grade. The latter have more risk of progression to cancer if left untreated.

Given the complexity of the classification, you should talk to your gynecologist and ask any questions you may have regarding pre-malignant lesions.

Not all women with precancerous lesions will develop cervical cancer.

The treatment of these lesions depend fundamentally on the persistence of them in successive test and grade (low or high) thereof.

Treatment is conservative and aims to destroy only the area where the injury is located. For this you can use surgery, laser or cryocoagulation (tissue destruction by cold).