Pap Tests and Cervical Cancer

Cervical cancer is 100 percent curable if detected early

What is the Pap test?

A Pap test is an examination of cells that are scraped or brushed off the cervix, and placed on a slide that can be looked at under a microscope. The purpose of the Pap test is to find changes that may lead to cervical cancer.

What is cancer of the cervix?

Cancer of the cervix is an abnormal growth of the cells lining the surface of the cervix. The cervix is the lower, narrow end of the uterus (womb). It opens into the vagina. It connects the womb with the vagina.

Who is at risk?

Women who had sex at an early age, had many sexual partners, or more than three pregnancies have a greater risk of cervical cancer. Smokers and young women whose mothers took DES while pregnant are also at risk. Cervical cancer can occur at any age. The peak for early cancer is between ages 30 and 40. The peak for invasive cancer is ages 40-50.

What are the symptoms?

Early cancers often cause no symptoms. Some women with early cervical cancer will have unusual bleeding or discharge, however. Late symptoms include pelvic pain, back pain and leg swelling.

How should I prepare for a Pap test?
  • Do not douche for at least three days before your Pap test. If you do, there won't be enough loose cells in your cervical fluid for an accurate test.
  • Do not use tampons, or use vaginal medications or contraceptives for 72 hours before your appointment.
  • Schedule your exam two weeks after the first day of your last period. Do not schedule it during your menstrual period.
Can a Pap test detect cancer of the uterus?

The Pap test is helpful in detecting cervical cancer. It is less accurate for finding cancer of the body of the uterus. It also does not usually find cancer of the fallopian tubes, or the ovaries.Any woman with cells suspicious for cancer on a Pap smear, should be carefully evaluated to determine the origin of the abnormal cells, which could include the vagina, cervix, uterus, fallopian tubes or ovaries.

What is dysplasia?

The cells covering the cervix go through mild to severe changes before becoming cancer. These changes are called dysplasia. Dysplasia does not always lead to cancer. It should be followed up and treated to avoid developing cancer. It most often occurs in women between the ages of 25 and 35. But it may also develop in women in their teens or early 20s. Exposure to the human papilloma virus during sexual relations is the cause of cervical dysplasia and cancer.

What happens if I have an abnormal Pap test?

A biopsy may be needed in order to get a diagnosis of dysplasia or cancer. Your doctor may also perform a colposcopy. During this exam, the doctor views the cervix with a colposcope. This gives a magnified view of the cervix. It shows greater detail than can be seen with normal vision. Biopsies can also be done during this exam.

If the biopsy is positive for cancer what other tests will I have?

Before treatment is started, the doctor will usually perform a chest x-ray and some blood tests. Other tests such as CT scans to check for cancer in the liver, kidneys or lymph nodes may also be advised.

What is the treatment for cervical cancer and dysplasia?

Cervical dysplasia can be treated with freezing, destroying with a laser, removal using a wire loop (LEEP), or by use of a scalpel. The type of treatment for cervical cancer depends on a number of factors. The doctor will explain what these are. Invasive cervical cancer will be treated with surgery and/or radiation therapy. Some patients may require chemotherapy.

There is a vaccine for certain types of HPV to prevent cervical dysplasia and cervical cancer. Talk to your doctor to see if you should receive this vaccine.

David Bender, MD

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