Thursday, 23 August 2018

Get Your Regular Screenings Before Cervical Cancer Gets You

Although without symptoms, the initial stage of cervical cancer can be detected through regular screenings (having a test without waiting for any symptom to appear). Several methods of cervical cancer screening known so far are:

1. Visual inspection with acetic acid (VIA)

This test is conducted by inspecting the cervix smeared with 3-5% acetic acid solution. Within 10 minutes, if the smear changes in color, showing some white patches for instance, there might be abnormalities in the cervical cells. Unfortunately, this method has lower sensitivity and specificity than other screening methods.

2. Cytologic examination (Pap smear/Pap test)

This is the test to inspect the morphological change (in form and function) of the cervical cells by the technique of Papanicolaou' s stain, to then be put under a microscope. The test sample for Pap smear is taken from the vaginal opening.

There are 2 kinds of Pap smear, namely conventional Pap smear and liquid-based cytology (LBC). However, in the LBC test the sample is put into a specific liquid to separate the cells from other distracting factors prior to being put under the microscope. It allows a more accurate microscopic view.

3. HPV-DNA test

HPV-DNA test is a molecular examination that aims to directly find out if there is HPV in the cells taken from the cervix. The Food and Drug Administration (FDA) has approved the use of the HPV-DNA test along with the Pap smear as a primary screening of cervix on women, especially at an age above 30 years old.

Who Needs the Screening?

Regular cervical cancer screening is highly recommended for all women having been engaged in a sexual intercourse. The conditions are detailed as follows:

If you are under 21 years old, the Pap smear screening is conducted 3 years after the first sexual intercourse. If the test result is normal, the future test is to be conducted once a year.

- If you are 21-30 years old: screening with Pap smear should be carried out once a year or according to your doctor' s recommendation in case of abnormal result.

- If you are above 30 years old: the Pap smear and the HPV-DNA tests must be taken regularly. Women older than 30 years old who are sexually active are at high risk of permanent HPV infection. This condition is closely related with the occurrence of cervical cancer.

The cervical cancer screening is also necessary for:

  1. Women having their uterus removed

- Before the removal, if the patients have abnormal Pap smear results (high-grade squamous intraepithelial lesion/HSIL), history of precancerous lesions (cervical intraepithelial neoplasia/CIN 2/3), or no experience of having a Pap smear test, the test should be conducted annually. If the results are negative for 3 consecutive years, the screenings can be stopped thereafter.

- Before the removal, if the patients have neither history of Pap smear tests nor abnormal HPV-DNA results, the screening is not necessarily conducted.

  1. Vaccinated women

In the post-vaccination period, the regular screening is still necessary because:

- The current available vaccine does not protect against all types of high-risk HPV (only types 16 and 18),

- The protection will be imperfect if the vaccine is not given completely, and

- The vaccine does not provide perfect protection for the patients already infected by HPV types 16 and 18.

During August to December 2018, Prodia is working with BPJS health to conduct a free pap smear examination program. For more information, click here.

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