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Cervical Cancer

An Early Diagnosis Best for Cervical Cancer


Author:

Craig Bissinger, MD

Morristown Memorial Hospital, Morristown, NJ

Medically Reviewed On: January 15, 2003

Introduction
At one time, cervical cancer was the number one cancer-related killer among American women. Now it is considered one of the most preventable cancers because of a simple test. Nearly all of the 16,000 newly-diagnosed cases this year will be treatable, if detected early enough with a Pap test.

The Virus and Cervical Cancer Connection
Cells inside the cervix are constantly being replaced and this process of cell division progresses normally until something triggers a change. These disruptions in normal cell division are nearly always caused by the human papilloma virus (HPV), also known as genital warts. The virus, introduced into the cervix during sexual intercourse, has the unique ability to infect the dividing cells of the cervix. Once inside the cell, HPV inserts itself into the DNA of the cervical cells and alters their ability to produce new cells. Over the course of many years, the cells tend to become cancerous. This process takes a long time, and an annual Pap test can detect some of these changes early on. Tests have been developed to detect the virus in tissue of the cervix, and they are now being used in conjunction with the Pap test to identify women at risk for cervical cancer.

What Is a Pap Test?
A Pap test, sometimes called a Pap smear, involves obtaining cells from the cervix, placing them on a glass slide, and later examining them under the microscope to visualize any abnormal cells. It is a quick and relatively painless process. Women often describe it as the feeling as an "internal pinch" when the brush touches the cervix. After the procedure, the sample is sent to the lab for analysis.

Even in the best labs, the Pap test is only 80% accurate. But with a regular schedule of Pap testing, the chance of missing an abnormality is very remote. Still, many doctors have switched to a newer type of Pap test called the ThinPrep Pap test. This test is slightly more accurate than the traditional Pap, yielding a 6-65% increase in detection of abnormal cells. In addition, HPV DNA testing can only be done in conjunction with the ThinPrep Pap technology.

If Pap test results suggest an abnormality, or if the results are unclear for any reason, there are a number of additional tests that can be performed. Colposcopy, loop electrical excision procedure (LEEP), and cone biopsy, are additional diagnostic tests that may be performed.

What Do The Test Results Mean?
After your Pap test is examined at the lab, your physician will receive a report describing the results of your test-satisfactory or unsatisfactory. On the report, there will be comments about the type of cells and a recommendation for follow-up care.

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