Cervical cancer screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Sarthak Sachdeva
Screening
You should start getting regular Pap tests at age 21, or within three years of the first time you have sex—which ever happens first. The Pap test is one of the most reliable and effective cancer screening tests available. It also can find other conditions that might need treatment, such as infection or inflammation. In addition to the Pap test—the main test for cervical cancer—the HPV test may be used for screening women aged 30 years and older, or women of any age who have unclear Pap test results. If you are 30 or older, and your screening tests are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another screening test for up to three years. But you should still go to the doctor regularly for a check-up that may include a pelvic exam. It also is important for you to continue getting a Pap test regularly—even if you think you are too old to have a child, or are not having sex anymore.
Types of Screening
- Conventional cytology
- Liquid based monolayer cytology
- Human papillomavirus testing
- Tests for resource poor areas
- Visual inspection
Biopsy
While the pap smear is an effective screening test, confirmation of the diagnosis of cervical cancer or pre-cancer requires a biopsy of the cervix. This is often done through colposcopy, a magnified visual inspection of the cervix aided by using an acetic acid (e.g. vinegar) solution to highlight abnormal cells on the surface of the cervix.
Further diagnostic procedures are loop electrical excision procedure (LEEP) and conization, in which the inner lining of the cervix is removed to be examined pathologically. These are carried out if the biopsy confirms severe cervical intraepithelial neoplasia.