What examinations and preparations are needed for cervical cancer detection? These are essential

The strategy of focusing on prevention as the main way to reduce the mortality rate of cervical cancer is simple and effective. The key to prevention and treatment is to timely detect and treat cervical lesions through screening and stop their development into cervical cancer. Cervical cancer screening is the first step in the prevention and treatment of cervical cancer. So what kind of examinations and preparations are needed for cervical cancer screening?

Cervical cancer screening

The first step in finding cervical cancer is often an abnormal Pap test result. This will lead to further testing that can diagnose cervical cancer.

Cervical cancer may also be suspected if you have symptoms such as abnormal vaginal bleeding or pain during intercourse. Your primary care doctor or gynecologist can usually do the tests needed to diagnose precancer and can also treat precancer.

If there is a diagnosis of invasive cancer, your doctor should refer you to a gynecologic oncologist, a doctor who specializes in cancers of the female reproductive system.

Testing for women with symptoms of cervical cancer or abnormal Pap test results

Medical history and physical examination

First, your doctor will ask about your personal and family medical history. This includes information about risk factors and symptoms of cervical cancer. A complete physical exam will help assess your overall health. Your doctor will do a pelvic exam and may order a Pap test if it hasn't already been done. In addition, your lymph nodes will be checked for evidence of metastasis (spread of the cancer).

The Pap test is a screening test, not a diagnostic test. It cannot confirm whether you have cervical cancer. An abnormal PAP test result may mean more testing, sometimes including a test to see if cancer or precancer is actually present. Tests used include colposcopy (with biopsy), endocervical scratch, and cone biopsy.

Colposcopy

If you have certain symptoms that suggest cancer, or if your Pap test results show abnormal cells, you'll need to have a procedure called a colposcopy. You'll lie on an exam table, just as you would for a pelvic exam. A microscope will be placed in the vagina to help the doctor see the cervix. The doctor will examine the cervix with a scope. A scope is an instrument held outside the body that has a magnifying lens. It gives the doctor a close and clear view of the surface of the cervix. The colposcopy itself is usually no more uncomfortable than any other microscopic examination. It can be done safely even if you're pregnant. Just like the Pap test, it's best not to have it done during your menstrual period.

Your doctor will put a weak acetic solution (similar to vinegar) on your cervix to make any abnormal areas easier to see. If an abnormal area is present, a biopsy (removal of a small piece of tissue) will be performed. The tissues are sent to a lab to be viewed under a microscope. A biopsy is the best way to determine if an abnormal area is precancerous, true cancer, or neither. While a colposcopy procedure is usually not painful, a cervical biopsy can cause discomfort, cramping, bleeding, or even pain in some women.

Cervical biopsy

Several types of biopsies can be used to diagnose cervical precancer and cancer. If the biopsy completely removes all of the abnormal tissue, this may be the only treatment needed.

Microscopic biopsy

For this type of biopsy, the cervix is ​​first examined with a scope to find abnormal areas. Using biopsy forceps, a small piece (about 1/8 inch) of the abnormal area on the surface of the cervix is ​​removed. The biopsy may cause mild cramping, brief pain, and some minor bleeding afterward. A local anesthetic is sometimes used to numb the cervix before the biopsy.

Cervical curettage (scrapectomy)

Sometimes, the transformation zone (the danger zone for HPV infection and precancer) cannot be seen under the microscope, and some other tests must be done to check if there is cancer in that area. This means inserting a narrow instrument (called a curette) into the endocervical canal (the part of the cervix closest to the uterus). The curette is used to scrape away some tissue from the inside of the canal, which is then sent to a lab for examination. After this procedure, the patient may feel cramping pain, and they may also have some light bleeding.

1. Four methods of cervical cancer screening

1. Colposcopy: When abnormalities are found in the cervical cytology smear examination, a colposcopy is required to confirm the lesion. If necessary, several pieces of tissue can be taken for pathological examination to provide a basis for surgical treatment.

2. Virological testing: Detection of high-risk human papillomavirus (HPV) genes. Current data show that HPV infection is the main cause of cervical cancer and its precancerous lesions. HPV virus can be found in 99.8% of cervical cancer patients. The latest method for detecting HPV infection approved for clinical use is the hybridization capture method.

Method: Use a special small brush to collect cells from the cervix, without any damage or pain to the patient. This method has a very high accuracy rate, but due to its high cost, it is usually only used in high-risk groups.

3. CCT - Computer-Assisted Film Reading System Americans have developed a system called "brain neural network simulation system" for scanning traditional Pap smears, namely CCT examination. However, statistical studies have shown that the sensitivity of the system's initial screening is lower than that of experienced professionals, so the US Food and Drug Administration (FDA) only approved it for laboratory quality control. After 2000, CCT has been replaced by a new generation of cytology automatic scanning systems.

4. TCT - Thin-layer cytology testing One of the main reasons for missed or misdiagnosed diagnoses with traditional Pap smears is the loss of cells during sampling and poor smear quality. In the 1990s, the new Pap smear technique (TCT) emerged.

2. What should I pay attention to before the inspection?

1. Empty your bowels in the morning on the day of the examination and empty your urine 10 minutes before the examination.

2. Women who are currently taking vaginal medication for gynecological problems should stop taking the medication for at least 2 days before undergoing examination.

3. Avoid the menstrual period. If there is irregular vaginal bleeding, especially bleeding after menstruation, it must be checked. Tell the doctor about the situation. The doctor can do the examination after strict disinfection.

4. Do not have sexual intercourse and avoid vaginal douching 48 hours before cervical cytology examination, otherwise it will not truly reflect the condition of the cervix.

5. In principle, women who have never had sexual intercourse do not need to undergo cervical cancer screening or gynecological examination. If they must do so due to other factors, please inform your doctor in advance.

6. During the examination, you must relax and treat it normally, because tension will cause the muscles of the vagina and cervix to contract and shrink, making it difficult for the doctor to take samples, and the person being examined will also feel uncomfortable.

Which age group is best for screening?

In my country's economically developed large and medium-sized cities, the starting age for screening can be considered to be 25-30 years old; in economically underdeveloped areas, the starting age for screening should be 35-40 years old. For high-risk women, the starting age for screening should be advanced accordingly. It is generally not recommended to screen women over 65 years old for cervical cancer.

What is the screening interval?

Women should have a cervical health checkup every year to prevent problems before they occur. The screening interval is once a year. If two consecutive cytological screenings are normal, the screening interval can be appropriately extended to 3 years. If two consecutive screenings are normal, the screening interval can be extended to 5-8 years. For people with weakened immune function, the screening interval should be shorter, preferably once a year. If two consecutive cytological screenings are normal, the screening interval can be appropriately extended to 3 years.