Cervical cancer is one of the major health problems in India with a high rate of occurrence among South Asian countries. When detected early, the extent and severity of the disease burden can be reduced.
Screening and early detection for cervical cancer have become more accessible now due to the availability of the vaccine against the virus responsible for cancer of the cervix. The detection rates have improved due to increased screenings because of awareness campaigns such as Cervical Cancer Awareness and counselling by healthcare professionals.
The affected women may present with pelvic pain or abnormal bleeding initially. When undetected for a longer period, symptoms such as loss of appetite, fatigue, weight loss, back pain, heavy vaginal bleeding, or bone fractures may occur. Here’s all you need to know from the expert, Dr Ravi Teja Juloori, Lab Head – TRUSTlab Diagnostics.
1. Conventional Pap smear: This simple non-invasive test identifies the changes in the cervical cells known as pre-cancerous lesions before cancer development. The scrapings from the cervical walls are collected, and the Pathologist screens the material to detect the cells that may be pre-cancerous/ cancerous. Women over 25, symptomatic women, and women with certain risk factors should get screened regularly (every 3–5 years) via PAP smear to detect pre-cancerous lesions.
Such lesions once identified may require additional testing with adjuvant tests and more frequent testing as determined by the primary healthcare provider.
2. Liquid-based cytology(LBC)PAP smear: This is a newer modality that helps in faster and better screening of the PAP smears prepared and allows for limited preservation of material for retesting and additional testing such as HPV testing when required.
3. HPV testing: The human papillomavirus is the causative factor in most cervical cancers. Fortunately, not all individuals with HPV infection develop cervical cancer. Amongst the many strains of HPV, few are associated with being causative, called high-risk types. The tests to detect the most common viral strains, for eg: 16 and 18, are helpful.
HPV testing for cervical cancer screening is a molecular test done with the same sample taken for PAPsmear (liquid-based cytology). The virus causes changes that may be visually detected in PAP smear tests as pre-cancerous lesions.
It is currently recommended to undergo HPV testing along with a PAP smear for cytology at regular intervals such as 5 years, beginning at age 25. Any detection of HPV or lesion on a PAP smear would require additional testing at more frequent intervals with further treatment as planned by the healthcare provider.
4. VIA: Visual inspection is an economical, non-invasive test available in a low-resource setting. Under direct visualisation with the help of magnification, the cervix is inspected after the application of certain agents such as acetic acid.
Detection of lesions is done through colour change after application. In a low-resource setting, it is recommended for women in the 30–65 years age group to undergo VIA testing every 5 years.
Cervical cancer is a cancer that is preventable by the use of a vaccine against high-risk HPV. Regular screening as mentioned above and guidance by the primary healthcare provider are an essential part of prevention efforts.
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Rohit Malhotra is a medical expert and health journalist who offers evidence-based advice on fitness, nutrition, and mental well-being. His articles aim to help readers lead healthier lives.
