Cervical cancer screening: Diseases and Various Testing Methods.

 

 

 

     Cervical Cancer is the most common cancer in Thai women, with approximately 7,000 new cases reported annually. It is most commonly diagnosed in women over the age of 35. The challenge with cervical cancer is that it often has no symptoms until it reaches an advanced stage, which makes it difficult to treat effectively.

 

 

     However, this cancer can be detected early when cellular abnormalities first occur. The disease progresses gradually over a relatively long period, and the cervix is located in a position that is easier to examine compared to other organs. This allows doctors to diagnose and treat the cancer at an early stage or even before it becomes invasive. Cervical cancer screening can thus help reduce the incidence of this disease.

 

Risk factors for cervical cancer

• Having sex at a young age
• Having multiple sexual partners
• A history of sexually transmitted infections (STIs)
• Smoking
• Immune system disorders or using immune-suppressing medications
• Infection with Human Papillomavirus (HPV)

 

Cervical Cancer Screening

1.  Pap Smear Test

     In 1992, the World Health Organization collected data and found that screening for cervical cancer using the Pap smear method every five years for women aged 35-60, with a coverage of 50% of the population, can reduce cervical cancer incidence by 44%. The Pap smear is a cost-effective, widely accepted, and commonly used method that has been practiced for many years.

 

Recommendations for women

• Women should have their first Pap smear test between 30 and 35 and continue regular screenings every 1-3 years.
• The frequency of screening depends on individual risk factors for cervical cancer, and the attending gynecologist will recommend how often it should be done.

 

 

 

 

 

 

Procedure for a Pap Smear

     A Pap smear can be performed during a pelvic examination in the doctor's office and takes only 1-2 minutes. A sample of cells from the cervix and vagina is collected and placed on a glass slide. The slide is then sent for staining and examined by a pathologist under a microscope to check for abnormal cells.

 

 

 

 

 

 

 

Pap Smear Test Results

     At Ramkhamhaeng Hospital, results are typically reported within 2-3 days. Several reporting systems are used, including the Papanicolaou Classification (Class I-V) and the Bethesda System (which provides detailed descriptions of the cells found). The attending gynecologist will interpret the report and inform the patient of the results.

 

Treatment for abnormal cervical findings

     If the Pap smear results show abnormalities, the attending gynecologist will interpret the report and develop an appropriate care plan, which may include additional tests or treatments. Recommendations may vary depending on the type of abnormality, such as prescribing antibiotics or vaginal suppositories followed by a repeat test, or a follow-up examination using a colposcope.

 

2.  Colposcope Examination

     A colposcopy is a tool used to examine and magnify the cervix to assess abnormalities. It has a magnification power of 6-40 times to observe abnormal color changes, borders, and blood vessels on the cervix and vagina. This method allows for accurate diagnosis and guides appropriate treatment.

 

 

 

 

3.  Liquid-based Cytology

     This is a laboratory method for cervical cancer screening. It uses a special tool to collect cells from the cervix, similar to the Pap smear method. The collected cells are placed in a liquid preservative, and automated equipment prepares the samples for analysis, removing contaminants like mucus and blood cells and reducing overlapping cells on the glass slide.

 

Advantages of Liquid-based Cytology

• It increases the chances of detecting abnormalities.
• Research has shown that this method provides more accurate results than the traditional Pap smear. However, it is more expensive.
• It is particularly useful for women at high risk for cervical cancer and for monitoring certain cervical conditions.

 

Additional Information: HPV Testing and Its Relationship with Cervical Cancer

 

 

---

Since cervical cancer often has no symptoms until it reaches an advanced stage, screening is essential for early detection, which can significantly reduce the risk of developing the disease.

---