Cervical cancers are caused by oncogenic, high-risk types of HPV which are sexually transmitted. Most HPV infections go away on their own within 1-2 years without any sequels. Cervical infection with high-risk HPV if persists can cause cellular changes which can develop into precancerous lesions and can eventually progress to cancer. It usually takes 10-20 years for a persistent infection with high-risk HPV to develop to cancer.
Screening for cervical cancer
It is done to detect precancerous and early cervical cancer lesions as these are completely curable. Two types of screening are available cytology-based called as PAP smear and HPV testing. PAP can detect abnormal cells, infections and inflammation. HPV testing detects the presence of high-risk HPV types in cervical cells.
How is the test done for Cervical Cancer
It is done in a clinic during a pelvic examination. A speculum is inserted into the vagina so that cervix is visible. Cells are taken with a wooden or plastic brush and sent to the laboratory after fixing. Conventional one is on a glass slide and liquid is collected in a vial of liquid. In a liquid, both cytology and HPV DNA can be done.
Age 21-29 should be screened with PAP every 3 years
Ages 30-65 can be screened with PAP and HPV co-testing every 5 years or with PAP alone every 3 years
Women with high-risk factors need to be screened more frequently and even after age 65. High risk are women with HIV, immunosuppressed, exposed to diethylstilbestrol before birth or treated for precancerous cervical lesion or cancer cervix
Women who had hysterectomy or removal of uterus and cervix need not be screened. If hysterectomy done for precancerous lesions then screening needs to continue