Cervical cancer is a prevalent and potentially life-threatening disease that affects thousands of women worldwide. According to the World Health Organization, it is the fourth most common cancer among women globally, with an estimated 604 000 new cases and 342 000 deaths in 2020, of which 90% occurred in low and middle-income countries.

Human Papilloma Virus (HPV), a sexually transmitted virus that affect both men and women, is the causative agent in 95% of cases of cervical cancer. High-risk HPV serotypes, namely HPV 16 and HPV 18, are the ones involved in the pathogenesis of cervical cancer. It is the most prevalent sexually transmitted infection worldwide, with the majority of sexually active individuals contracting it at some point in their lives. Fortunately, early detection through cervical cancer screening and anti-HPV vaccination have proven to be highly effective means of decreasing the burden of mortality and morbidity throughout the world.

THE IMPORTANCE OF CERVICAL CANCER SCREENING

Regular cervical cancer screenings play a vital role in identifying abnormal changes in the cervix at an early stage, even before cancer develops. Detecting precancerous cells allows for timely intervention, significantly increasing the chances of successful treatment and preventing the progression to invasive cancer. Some studies found that both incidence and mortality from cervical cancer have sharply decreased in a number of large populations after the introduction of well-run screening programs.

THE SCREENING METHODS

Papanicolaou test (Pap smear): The primary purpose of a Pap smear is to identify any abnormal cells in the cervix that could indicate precancerous conditions or early-stage cervical cancer. By detecting these changes early, further diagnostic tests can be conducted, and appropriate medical interventions can be initiated to prevent the progression of the disease.

The recommended age to start Pap smears and the frequency of screening can vary depending on factors such as individual risk factors and local guidelines. In general, it is recommended to begin screening at the age of 21, regardless of sexual activity. For women between the ages of 21 and 29, Pap smears are typically recommended every three years. From the age of 30 to 65, three options are available: a) Pap smear alone every three years; b) Pap smear-hrHPV co-testing every five years; c) hrHPV testing alone every five years.

HrHPV testing: This involves analyzing the collected cervical cells for the presence of high-risk HPV strains that are known to cause cervical cancer. Co-testing with both Pap smears and hrHPV testing can provide a more comprehensive evaluation of cervical health and help identify women at higher risk.

A FEW PARTICULARITIES

While regular cervical cancer screening is generally recommended for most women, there are certain exceptions and special circumstances where screening guidelines may differ. Here are some exceptions to the cervical cancer screening guidelines:

Age: The age at which cervical cancer screening begins and the frequency of screening can vary depending on guidelines. In some cases, women may be advised to start screening earlier or continue screening beyond the recommended age range. Consulting with a healthcare provider can help determine the appropriate screening schedule based on individual circumstances.

Immunocompromised Individuals: Women with weakened immune systems, such as those living with HIV/AIDS or undergoing organ transplantation, may be at higher risk of developing cervical cancer. These individuals may require more frequent screenings or additional diagnostic tests, as their immune system may not effectively clear HPV infections or identify abnormal cervical cell changes.

Previous Abnormal Results: If a woman has previously had abnormal Pap smear results, she may need more frequent screenings or additional tests, such as colposcopy or biopsy, to closely monitor any changes in cervical cells.

Hysterectomy: Women who have undergone a total hysterectomy (removal of the uterus and cervix) for non-cancerous conditions, such as uterine fibroids, may not require further cervical cancer screening. However, if the hysterectomy was performed due to cervical cancer or precancerous conditions, ongoing screening or monitoring may be necessary.

CONCLUSION

Cervical cancer screening is a powerful tool for early detection and prevention of this potentially deadly disease. Whether through Pap smears, HPV testing, or visual inspections, regular screenings empower women to take control of their health and ensure timely medical intervention when needed. By staying informed about recommended screening guidelines and proactively engaging in preventive healthcare, women can significantly reduce their risk of cancer and pave the way for a healthier future. Remember, your well-being is worth prioritizing, and early detection truly saves lives.

Yours in good health

MDLINE HEALTH