The HPV screening

Not only does a pap smear detect cancer early, but it also catches abnormal changes before they have a chance to develop into cancer, writes Shilpi Madan

Wondering when and if to get a check done for cervical cancer or whether the HPV vaccine needs to be taken? Here’s a guide to ensure precancerous cervical cell changes are detected early so as to enable you to work with your provider to lower the chances of developing cancer. 

The smear

A pap smear is a test used by gynaecologists during a routine examination at three yearly intervals to screen for cervical cancer. Dr Vaishali Joshi, obstetrician and gynaecologist at Kokilaben Ambani Hospital, Mumbai adds, “Pap smear is one of the preventive tests to pick up the pre-cancerous or early cancerous changes in the cervix (neck of the womb) in healthy women who have no symptoms of cervical cancer. It needs to be done at any time if a woman is experiencing excessive vaginal discharge, bleeding after sex, or bleeding between two periods. 

Cervical cancer develops over 8-9 years starting mainly due to Human Papilloma Virus (HPV) infection leading to pre-cancerous changes in the cervix. It is one of the leading cancers found in a woman. If a test can detect these changes before cancer sets in, then we can treat the cancer completely.” The test involves picking up cells from the cervix that are transferred on a glass slide and transported in a special chamber box to the cytology laboratory. The slides are fixed with special stains and the cells are examined under the microscope, she explains.

• A pap smear cannot be performed during periods. It is essential to schedule your gynaecological visit after the completion of the period.

• Perform it ideally in the first 7-10 days after your period. 

• Avoid the following at least 2-3 days prior — having sex, usage of vaginal pessaries or tampons, application of vaginal creams, and vaginal douche. 

• Occasionally one may experience spotting after the test. Carry a panty-liner to avoid staining.

HPV’s a must

Is the vaccine for cervical cancer necessary? Says Dr Surabhi Siddhartha, Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharghar, “The HPV (human papillomavirus) vaccination is now recommended for both boys and girls. It prevents HPV-related malignancies and genital warts. If a person receives the series of doses before becoming sexually active, the vaccine has the highest chance of guarding against infection, vaginal and vulvar cancer, anal cancers, and mouth, throat, head, and neck cancers in both men and women.

• The vaccine is best administered before 30 years of age.

• It is best given at 12-13 years, and basically before the girl is sexually active.

• For males, just one HPV vaccination (Gardasil) is advised. This vaccination can help protect males from HPV-types that can cause malignancies of the mouth/throat, penis, and anus, as well as genital warts.

Who should get a pap smear done  

• PAP smears are to be done only if the person has been sexually active.

• At 65 yrs, skip PAP if previous smears reported negative for cancer.

• The test needs to be done in all sexually active women above the age of 25.

• Regular PAP smear is essential as the HPV vaccine gives only partial protection against infinite HPV viruses.