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Cervical Cancer: Symptoms, Causes, Types and Tests

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Cervical cancer is a type of cancer that develops in the cells of the cervix, which connects the uterus to the vagina. Most cervical cancers are caused by different strains of the human papillomavirus (HPV), a sexually transmitted infection. When HPV is in the body, the immune system usually stops it from doing damage. However, the virus can live for years in a small number of people. This makes some cervical cells more likely to turn into cancer cells.

Screening for cervical cancer is important as it can help detect the disease early before it turns deadly.

Signs and Symptoms of Cervical Cancer

The following are the symptoms of cervical cancer:

  • Bleeding from the genitalia after sexual activity, during menstruation, or after menopause. 
  • Discharge from the vaginal area that is watery and bloody and may be thick and unpleasant-smelling.
  • Discomfort in the pelvis or during sexual activity.

Causes of Cervical Cancer

Long-lasting infection with some types of HPV is the primary cause of cervical cancer. HPV is a group of viruses that are found all over the world in large numbers. There are more than 100 different kinds of HPV, and at least 14 of them cause cancer (also known as high-risk types). At least 70% of cervical cancers and pre-cancerous lesions are caused by HPV types 16 and 18.

Types of Cervical Cancer

Treatment and prognosis for cervical cancer depend on the specific subtype of the disease. Types most commonly associated with cervical cancer include:

  1. Cancer of the squamous cells. This type of cervical cancer develops in the squamous cells that line the thin, flat outer cervix and extend into the vagina. Squamous cell carcinomas are the most common type of cervical cancer.
  2. Adenocarcinoma. The columnar glandular cells lining the cervix are the first sites of development for this subtype of cervical cancer.

Cervical Cancer Screening

Cervical cancer screenings look for pre-cancerous changes in cervical cells so they can be treated and cancer can be avoided. Cervical cancer is occasionally discovered during routine screening. When cervical cancer is detected early, it is more likely to be treated successfully. By the time symptoms of cervical cancer show up, cancer may have already spread, making it harder to treat.

Screening for cervical cancer may consist of either an HPV test or a Pap smear, or even both.

Pap Smear:

  • A Pap smear, sometimes called a Pap test, is a screening procedure for cervical cancer.
  • The cervix, the thin end of the uterus at the top of the vagina, is where cells are collected for a Pap smear.
  • Cervical cancer has a higher cure rate when detected early using a Pap smear. A Pap test can also detect cervical cell alterations that may eventually lead to cancer. These abnormal cells can be detected with a Pap smear at an early stage. As such, we have taken the first step in preventing cervical cancer.
  • The Pap smear is typically performed alongside a pelvic exam. HPV is a sexually transmitted infection that can cause cervical cancer, and the Pap test may include an HPV test for women over the age of 30. An HPV test can be used as an alternative to a Pap smear in some situations.

HPV Blood Test:

  • The human papillomavirus (HPV) test is used to identify this virus. 
  • Instead of using a smear, this test looks at the patient's DNA to detect cancer.
  • The HPV test checks for cervical cancer, but it doesn't tell you if you have cancer. Instead, the test checks to see if you have HPV, which is the virus that causes cervical cancer. Some types of HPV, like 16 and 18, can make you more likely to get cervical cancer.

LBC Test: 

  • Liquid-based cytology (LBC) is a method to check for cervical cancer in which cells are dissolved in liquid and then looked at.  
  • LBC testing is also called ThinPrep. 
  • It was approved by the Food and Drug Administration (FDA) in 2000 and is now the main method of checking for cervical cancer.
  • The LBC test can detect both low-grade cervical alterations and high-risk HPV. 
  • The traditional Pap smear is more invasive and less reliable than this test. 
  • With LBC, the possibility of false positives is also reduced. However, it has limited application and can only be used for cervical cancer screening.
  • However, the traditional Pap smear test can only screen for cervical cancer; it can't locate HPV or small changes in the cervix. Because of this, the LBC sample should also be sent for HPV testing.

Benefits of LBC with HPV testing over PAP testing

LBC + HPV TESTINGPAP SMEAR TESTING
Higher Detection Rate: the HPV test is meant to identify the HPV virus responsible for cellular alterations.The detection rate is lower than in LBC+HPV testing 
Highly sensitive for detecting precancerous cells than Pap smear Less sensitive to precancerous cells 
LBC+HPV testing has high specificity than pap Smear testing Low specificity that LBC+ HPV testing
The HPV test has a higher negative predictive value.Has a lower negative predictive value
False-positive results are less common.False-positive results are more common.
The results of an HPV test are more straightforward to interpret.Results are more difficult to interpret than HPV testing
LBC +HPV testing is less invasive than Pap Smear testingMore invasive than LBC+ HPV testing
LBC+ HPV testing requires less time compared to Pap Smear.Pap smear takes up more time than LBC+HPV testing.

Screening for cervical cancer is vital because it enables diagnosis at an easily treated stage. Screening tests for cervical cancer, such as the human papillomavirus (HPV) test and the Pap smear, can catch potentially lethal alterations in cervix cells at an early, treatable stage.

When to Have a Cervical Cancer Screening?

Several groups, like the United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS), make recommendations about cervical screening. Your age and health history depend on how often and what tests you should get to check for cervical cancer. Since HPV vaccination does not protect against infection with all high-risk HPV types, people who have been vaccinated and have a cervix should follow the guidelines for cervical cancer screening.

  1. Women between the ages of 21-29

The USPSTF says that women in this age range should start getting Pap tests at age 21 and then get tested every three years after that. A Pap test before turning 21 is unnecessary, regardless of sexual activity.

  1. Women between the ages of 30-65

According to the USPSTF, women of this age group should get cervical cancer screening using one of the following methods.

  • The HPV test should be performed every five years.
  • Test for HPV and Pap once every five years
  • A Pap smear every three years.
  1. Women over 65

Consult your doctor if you fall into this age group to determine if you still need to be screened. If you've been getting checked regularly and the findings have always been normal, your doctor may tell you that you can stop. But people over 65 may need to be screened if their previous test results were strange or if they haven't been tested regularly.

Conclusion

Screening for cervical cancer is vital because it enables diagnosis at an easily treatable stage. Cervical cancer screening tests, like the human papillomavirus test and the Pap smear, can detect changes in the cervix cells at an early, treatable stage which can turn deadly later.

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