Cervical Cancer Screening
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Cervical cancer ( cervix is the area at the neck of the womb - uterus) is the easiest gynecologic cancer to prevent, with vaccines and regular screening tests and follow-up.
Screening Tests : Screening tests can help prevent cervical cancer or find it early:
Two screening tests can help prevent cervical cancer or find it early—
- The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
- The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.
The Pap test is recommended for all women between the ages of 21 and 65 years old, and can be done in a doctor's office or clinic. Abnormal reports of Pap smear and HPV testing warrants further diagnostic tests like colposcopy and biopsy ( taking small piece from that area) is essential to rule out cervical cancer.
It is an examination of the cervix (neck of the womb) using a specially designed magnifying lens (colposcope). This allows the Doctor and the patient to look at cell changes on the cervix. Colposcopy is usually carried out when abnormal cells have been found during a PAP smear test. This usually means that minor changes exist in the cells on the cervix and in many cases these minor changes return to normal on their own. Sometimes the changes become worse and could possibly lead to cancer in the future.
How is Colposcopy Performed?
- Colposcopy is similar to having a smear test; a speculum is inserted into the vagina so that the opening of the cervix can be seen, and is then viewed using a colposcope (this is not inserted into the body).
- If any abnormal cells are detected a small tissue sample will be taken from the cervix (biopsy), and then examined under a microscope. If the abnormal cells go further into the cervix a cone biopsy may be required (this is where a larger cone shaped tissue sample is taken)
- It is recommended that colposcopy isn't carried out when you have your period, as this can make the cervix difficult to see.
- A colposcopy will show whether or not treatment is needed. If treatment is required this is usually carried out under local anaesthesia in the clinic with diagnostic biopsies taken at the same time.
Colposcopy may be recommended if you have:
• An identified abnormality on the cervix
• Bleeding after intercourse
• Bleeding between periods
• Persistent vaginal discharge
Vulvoscopy is an examination of the vulva skin surface of the perineum and labia and vaginal opening using a magnifying lens system (colposcope). This allows the Doctor to look at cell changes on the vulva.
When is a Vulvoscopy Required?
A vulvoscopy may be recommended if you have:
• Vulva pain or soreness
• Any visible abnormalities such as lesions or skin whitening
• Vulval pain during sexual intercourse
• Itching / Burning
How is a Vulvoscopy Performed?
- A Colposcope (medical microscope) is used to magnify the area (this is not inserted into the body) so any abnormal changes may be seen clearly by the Doctor. If during the examination abnormal cells are detected, a small biopsy (tissue sample) will be taken under local anaesthetic to be examined for abnormal cells.
- A Vulvoscopy will show whether or not treatment is needed. If treatment is required this is usually carried out under local anesthetic in the clinic once the biopsy results are available. If the area is widespread or treatment such as laser is required this is done under general anaesthetic as an inpatient in hospital.
Leep & Cryotherapy
Inexpensive, easy to perform, tolerated well by patients, OPD Procedue, No Anaesthesia
Nitrous oxide & CO2--- -22oC
Cells are destroyed by (cold) thermal damage 3 minute freeze/ 1 minute thaw/ 3 minute freeze
Intracellular water crystallization & cell burst
Ice ball-5-7 mm beyond lesion , depth >=5mm
Loop electrosurgical excision procedure.- Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric current to remove cells and tissue as part of the diagnosis and treatment for abnormal or cancerous conditions in a woman’s lower genital tract.
Two vaccines –Gardasil & Cervarix are available for cervical cancer prevention for age group 9-45 yrs. With this vaccine, teenagers and young women can now be 100% protected against infection with the two viruses most commonly linked to cervical smear abnormalities and cervical cancer itself (Human Papilloma Virus 16 and 18).
Cervarix (GSK) protects againts 16 and 18 HPV strains.
Gardasil (MSD) also protects against the less common HPV strains 6 and 11 apart from 16 & 18 that can also occasionally cause smear problems, and infection with genital warts, a sexually transmitted infection.
The vaccine is given in 3 doses over a six month period.
Please contact us if you wish to have the vaccine, or to arrange it for your daughter