Cervical Cancer: An Introduction

Like other cancers, cervical cancer has stages. When cervical cancer is detected before it has spread from the cervix to other parts of the body, it has much higher chances of a cure. Here are some factors that would increase the risk of developing cervical changes leading to cervical cancer:

1. A personal history of precancerous changes of the cervix or cervical cancer.

2. Being infected with certain types of the human papillomavirus (HPV) or human immunodeficiency virus (HIV).

3. Having a previous abnormal Pap test.

4. Starting sexual intercourse at an early age (younger than 18 years old).

5. Having three or more sex partners in a lifetime or a partner who has had multiple sex partners.

6. Having a weakened immune system.

7. Smoking.

8. Use of birth control pills (oral contraceptives) for more than 5 years.

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Factors Affecting Pap Smear Test

There are factors to be considered when making the pap smear test:
1. Menstrual Blood

2. Dried Out Cells: This is due to not applying the preservative to the slide immediately after the cells of the cervix are spread on it.

3. Douching, Use of vaginal lubricants and medications: This may wash away or coat the cells on the surface of the cervix.

4. Inadequate Cell sample: Your doctor may not remove an adequate sample of the abnormal area of the cervix, or the sample may contain too few cells, which may give a false-negative test result.

Epithelial Cell Abnormalities

This is one of the statements to indicate if the cells collected were normal or abnormal.

A. Squamous Cell Abnormalities
A.1 Atypical squamous cells (ASC). In this category, there are minor cell changes from unknown causes. It is further divided into two types:
A.1.1 ASC-US: ASC of undetermined significance
A.1.2 ASC-H: ASC that cannot exclude high- grade squamous intraephithelial lesion(HSIL).

A.2 Low-grade squamous intraepithelial lesions (LSIL). In this category, there are cells that show definite minor changes but are unlikely to progress to cancer. It includes the presence of human papillomavirus (HPV) infection, mild dysplasia, and cervical intraepithelial neoplasia (CIN 1).

A.3 High-grade squamous intraepithelial lesions (HSIL). In this category, there are cell changes that have a higher likelihood of progressing to cancer. It includes the presence of moderate to severe dysplasia, carcinoma in situ (CIS), CIN 2 and CIN 3, or changes suspicious for invasive cancer.

A.4 Squamous cell invasive cancer.


B. Glandular Cell Abnormalities
B.1 Atypical glandular cells (ACG) include:
B.1.1 Endocervical (from cervical canal) cells.
B.1.2Endometrial cells. These cells are normally found in the uterus. Their presence in the cervix might occur in menstruating women but would be abnormal in postmenopausal women who are not on hormonal replacement therapy.

B.2 Glandular cells.
B.2.1 Atypical glandular cells (neoplastic changes)
B.2.2 Endocervical cells
B.2.3 Glandular cells

B.3 Endocervical adenocarcinoma in situ (AIS)

B.4 Adenocarcinoma
B.4.1 Endocervical
B.4.2 Endometrial
B.4.3 Extrauterine
B.4.4 Other, not specified

Pap Test: How it is Done?

Here’s a step-by-step procedure to do the Pap test:
1. First is to take off your clothes below your waist and lie down on your back on a table with your feet raised, which is supported b stirrups.

2. Your doctor will insert a speculum, an instrument with curved blades, into your vagina. The speculum will spread the vaginal walls.

3. Your doctor will insert a cotton swab, with a tiny brush and a small wooden spatula, with a larger brush called a cervix brush, or with an extended tip spatula to scrape away several samples of cells from the cervix.

4. Your doctor will smear the collected cells on a slide, preserved, and ten sent to the laboratory for examination.

How to Prepare Pap Smear Test

Always remember not to use douche, tampons or any vaginal medications for at least 24 hours before doing a Pap test. Never make sexual intercourse too.

It is also recommended to do the test when you are not having your monthly period because the blood cells may interfere the Pap smear result. And for your comfort and so with your doctor, empty your bladder just before the test.

Why Pap Smear or Pap Test is Done?

The main reason why a pap test or pap smear is done is to screen for cancerous and precancerous cells of the cervix.

There is actually a recommendation to do the test from the onset of sexual intercourse to age 65. Pap test should be done every 1 to 3 years for women without risk factors for cervical cancer. For women who have had hysterectomy because of precancerous or cancerous changes in the cervix, a continuous regular pap smear must be observed. But for women who have had hysterectomy with the cervix removed for non-cancerous or benign reasons do not need to continue Pap test. While women who have had weakened immune system may need to test more often than once a year.