Most women celebrate when I tell them about the new guidelines. We still recommend a pelvic exam every year to look for other problems like ovarian cancer, uterine cancer, or sexually transmitted diseases. We know through research that nearly every case of cervical cancer is caused by HPV infection.
There are more than strains of HPV, but researchers have identified two types of HPV that are responsible for 70 percent of all cases of cervical cancer.
A vaccine is now available to preteens and teens to help prevent the most dangerous strains of HPV. Most people have been exposed to HPV at some point in their lives. Your immune system usually helps you get rid of the virus within a couple years, but in some people, the virus remains and damages cells. Ninety percent of HPV infections affect women when they are between 21 and 24 years old. The cervical cancer screening guidelines reflect this.
We test women more often when they are in that prime age group for HPV exposure. Then, when they turn 30, we start screening for HPV.
You feel fine. It could save your life. Routine cervical screening has been shown to greatly reduce both the number of cervical cancer cases and deaths from the disease. For many years, cytology -based screening, known as the Pap test or Pap smear, was the only method of screening. Its use reduced cervical cancer incidence and deaths in countries where screening is common.
Cervical cancer screening can be done in a medical office, a clinic, or a community health center. It is often done during a pelvic examination. While a woman lies on an exam table, a health care professional inserts an instrument called a speculum into her vagina to widen it so that the upper portion of the vagina and the cervix can be seen. This procedure also allows the health care professional to take a sample of cervical cells.
Researchers have found that screening may be less effective for obese women , possibly because of challenges in visualizing the cervix and obtaining a cell sample. Approaches to improve cervical visualization in obese women, including the use of larger speculum, may be helpful. Women should talk with their doctor about when to start screening and how often to be screened.
The updated guidelines are as follows:. A joint statement released by the American College of Obstetricians and Gynecologists, American Society for Colposcopy and Cervical Pathology, and the Society of Gynecologic Oncology noted that the updated guidelines are largely in line with their clinical guidance, with some differences in the details.
Although HPV infection of the cervix is very common, most infections will be controlled by the immune system over the course of 1 to 2 years.
Because most HPV infections are transient and produce only temporary changes in cervical cells, overly frequent screening could detect HPV infections or cell changes that would never cause cancer. Treating abnormalities that would have gone away on their own can cause needless psychological stress. Follow-up tests and treatments can also be uncomfortable, and the removal of cervical tissue has the potential to weaken the cervix and may affect fertility or slightly increase the rate of premature delivery, depending on how much tissue is removed.
These screening intervals also limit false-negative results that would delay the diagnosis and treatment of a precancerous condition or cancer. With these intervals, if an HPV infection or cell changes are missed at one screening exam, chances are good that those changes will be detected at the next one, when they can still be treated successfully. The success of cervical cancer screening is due, in part, to the repeat testing that women typically undergo over many years.
Therefore, a woman with a negative HPV test and normal Pap test—or just a negative HPV test—has a very low risk of developing precancerous cervical lesions over the next several years. It is for that reason that, when Pap and HPV cotesting or HPV testing alone are used, the recommended screening interval is 5 years: this longer interval compared with 3 years for women receiving Pap testing alone still allows abnormalities to be detected in time to treat them while reducing the detection of HPV infections that would be successfully controlled by the immune system.
Both Pap and HPV cotesting and HPV testing alone may also improve the detection of glandular cell abnormalities, including adenocarcinoma of the cervix cancer of the glandular cells of the cervix.
Glandular cells are mucus -producing cells found in the endocervical canal the opening in the center of the cervix or in the lining of the uterus. Glandular cell abnormalities and adenocarcinoma of the cervix are less common than squamous cell abnormalities and squamous cell carcinoma.
Pap testing is not as good at detecting adenocarcinoma and glandular cell abnormalities as it is at detecting squamous cell abnormalities and cancers. A woman may want to ask her provider for specific information about her Pap and HPV test results and what these results mean. Most laboratories in the United States use a standard set of terms, called the Bethesda System, to report Pap test results.
Pap test results also indicate whether the specimen was satisfactory or unsatisfactory for examination. Guidelines committees are re-evaluating how results of cervical screening tests are reported, based on the most up-to-date research on the natural history of HPV infections. The Bethesda System considers abnormalities of squamous cells and glandular cells separately. Squamous cell abnormalities are divided into the following categories, ranging from the mildest to the most severe.
Glandular cell abnormalities describe abnormal changes that occur in the glandular tissues of the cervix. The Bethesda system divides these abnormalities into the following categories:.
Depending on the test results, a woman may be recommended to have repeat screening in a year because some abnormalities, especially more minor ones ASC-US , will go away on their own as the immune system controls the HPV infection. During a colposcopy, the provider inserts a speculum into the vagina to widen it and may apply a dilute vinegar solution to the cervix, which causes areas of HPV infection, inflammation , precancer, or other cell changes to turn white.
The provider then uses the colposcope which remains outside the body to examine the cervix. When a provider performs colposcopy, he or she will usually remove cells or tissues from one or more concerning areas for examination under a microscope, a procedure called a biopsy.
Sometimes, after many years of negative HPV tests, an infection that the immune system had previously controlled can become active again, resulting in an HPV-positive test result. Such reactivation of an old, previously undetectable HPV infection can happen due to age-related changes in the immune system. There is no way to tell whether a newly positive HPV result is a sign of a new infection or represents a reactivation of an old infection.
It is also not yet known whether reactivated HPV infections can cause cell changes that lead to precancer and cancer. Current HPV vaccines do not protect against all HPV types that cause cervical cancer, so it is important for vaccinated women to continue to undergo routine cervical cancer screening.
Several new tests are currently in development that can improve the evaluation of HPV-positive women. One test that is undergoing regulatory evaluation but is not yet clinically available is based on detection of two proteins that indicate an active HPV infection—p16 and Ki The images can be taken with a cell phone or similar device outfitted with a camera, making this approach potentially useful for cervical screening in low-resource settings. Another improvement that may be of particular importance where healthcare resources are limited is the ability to do self-sampling.
A clinical study conducted among more than , women in the Netherlands found that HPV testing done on cervical samples collected by women themselves had similar accuracy to that of clinician-collected samples for the detection of moderately to severely abnormal cervical cells. These findings suggest that self-sampling has the potential be used as a primary screening method in routine cervical screening.
Menu Contact Dictionary Search. Understanding Cancer. What Is Cancer? Cancer Statistics. Cancer Disparities. Cancer Causes and Prevention. Risk Factors. Cancer Prevention Overview. Cancer Screening Overview. Screening Tests. Diagnosis and Staging. Questions to Ask about Your Diagnosis. Types of Cancer Treatment. Side Effects of Cancer Treatment.
Clinical Trials Information. Some strains of HPV are known to cause cervical cancer or oropharyngeal cancer, some strains of HPV can cause genital warts, and many strains cause no apparent signs or symptoms at all and are cleared by the immune system after two or three years. If pre-cancerous or abnormal cells are found, they can be frozen off via a method called cryotherapy.
If cancer is discovered doctors can remove or destroy the affected part of the cervix. Cervical cancer can be fatal if not discovered and treated early, however, if it is caught in time it can be treated and cured before it progresses and spreads.
Wearing condoms can prevent both women and men from contracting HPV. There are also vaccine and immunization series available for men and women to prevent contracting certain cancer-causing strains of HPV. Typically, STD tests are not conducted unless specifically asked for , and there are different tests for different STDs, so in order to get tested for multiple STDs, you will have to provide a blood and urine sample.
For example, trichomoniasis is often accompanied by foul-smelling, yellow or green discharge, and genital herpes outbreaks are characterized by lesions or sores on or near the genitals.
That being said, most cases of STDs are asymptomatic, meaning no signs or symptoms are present. Ask for all the STD tests you wish to have done to be completed. Your doctor will be able to test you for HIV, hepatitis B and C, gonorrhea, trichomoniasis, chlamydia, syphilis and herpes type 1 and type 2 if you ask. They should also be able to test you for hepatitis A if you request it. It is important to get tested for STDs so that you are aware of your current sexual health.
Getting tested is the first step to getting treatment for possible bacterial or viral infections that you may not have realized you have, as helping to stop the spread of STDs. Nick Corlis is a writer, marketer, and designer.
0コメント