Cervıcal Screenıng Test
Cervical Screening Test, also known in medical terms as the Pap Smear Test, was named after the Greek doctor George Papanicolaou and is used for screening cervical cancer. It plays an important role in detecting cancer or precancerous changes in the cervix. Precancerous cells are located on the surface of the cervix. With this screening test, these cells can be collected and examined. The Pap Smear Test has been successful in diagnosing cervical cancers and reducing mortality caused by the disease.
Why is the Cervical Screening Test Performed?
The purpose of the Cervical Screening Test is to detect certain abnormalities in the cervix (cervix uteri) that are not cancerous but may develop into cancer over many years if left undetected. By identifying these abnormalities early, they can be treated and eliminated before they turn into cancer. The main goal of this test is not to detect individuals who already have cervical cancer, but rather to identify precancerous changes years before cancer develops.
Women who do not undergo the Pap Smear Test may not notice these abnormalities, which could develop into cancer over time. Medical experts generally recommend that women aged 21 to 65 undergo cervical screening every three years. For women aged 30 and older, if the procedure is combined with an HPV test, cervical screening may be performed every five years, or they may consider an HPV test instead of a Pap smear test.
What Should Be Done Before Taking the Test?
In the 24 hours before the test, tampons, vaginal creams, or medications should not be used, and sexual intercourse should be avoided. Additionally, vaginal douching should be avoided. This is because these actions can wash away important cells, leading to incorrect test results. If there is a genital infection or abnormal discharge, a smear test should be performed after treatment.
How is the Cervical Screening Test Performed?
The Cervical Screening Test is a very simple, quick, and painless procedure. Since it is a non-invasive test, it does not cause pain or discomfort. The procedure takes only about 15-20 seconds and can be performed during a routine gynecological examination. During the examination, a speculum is inserted into the vagina to visualize the cervix.
Visible lesions on the vagina and cervix are examined, and a soft brush or spatula is used to collect a sample from the cervix. The collected sample is placed on a special thin glass slide called a "lam," and then immersed in an alcohol-filled container to preserve the cells. A fixative spray is applied to prevent deterioration. This process, known as fixation, prepares the sample for pathological examination. The results typically take between 2 to 8 days.
Tools and tests used for cervical screening include:
Pap Smear Test
The Pap test is usually the first step in assessing cervical health and is performed as part of routine screening. Most women are advised to begin Pap testing at age 21. Depending on age and risk factors, doctors may also recommend an additional HPV test. The cervical screening test plays an important role in identifying the risk of cervical cancer.
Pelvic Examination
A doctor manually examines the vagina, cervix, uterus, fallopian tubes, and ovaries for lumps or abnormalities that may require further imaging studies.
Colposcopy
A doctor uses a special microscope called a colposcope to examine the cervix. This microscope is designed to provide a magnified view of the area, allowing the doctor to detect any abnormal tissue. If abnormal tissue is identified, a biopsy is performed. You can read more about colposcopy for further details.
Biopsies
There are two types of biopsies used to diagnose cervical cancer. These include:
Conization Biopsy
If the results of the Pap test and colposcopy indicate cervical carcinoma, your doctor may perform a conization biopsy to confirm the diagnosis. Using a scalpel, the doctor removes a small tissue sample from the cervix. This sample is then sent to a pathologist for further examination.
Sentinel Lymph Node Biopsy
This test involves examining the sentinel lymph nodes, which are the lymph nodes most likely to contain cancer cells that have spread from a primary tumor. It helps determine whether cancer has spread beyond the cervix.