In 2020, about 1422 Canadian women were diagnosed with cervical cancer and an estimated 637 died from it. It is the third most gynecologic cancer in Canada after corpus uteri and ovary cancer. Screening tests help find cervical cancer before any symptoms develop. When cervical cancer is found and treated early, the chances of successful treatment are better.
Screening:
The Pap smear screening technique or conventional cytology screening is also known as exfoliative cervicovaginal cytology. It has been used from as far as 1927 when Papanicolaou was introduced and has for many years been in use. The most effective method of screening employed in the developed world has been cytology-based using Pap smears, which has contributed considerably to reducing the incidence of and mortality from, cervical cancer.
Sexually active women by the age of 21 should start having regular Pap tests. Pap test is done every 1 to 3 years. Women at high risk for cervical cancer may need to be tested more often and at an earlier age than women with average risk.
A Pap test is a quick and simple test and it checks for any changes in cells of the cervix. Regular Pap tests may help to prevent cervical cancer by finding cervical cell changes in your body that would become cancer if left untreated. A Pap test helps find cervical cancer early before you have symptoms. A Pap test helps find cervical cancer before it spreads when it is easier to treat. Early detection may mean less treatment and less time spent recovering. The earlier cervical cancer is detected, the better your chance of survival.
Diagnosing:
Diagnosing cervical cancer begins when a Pap test becomes abnormal. HPV DNA Screening, which is although expensive, can be cost-effective in the long run, as it has higher sensitivity than cytological screening, can detect CIN lesions at an earlier stage than cytology, and hence can be implemented with longer intervals between screenings while at the same time reducing cervical cancer incidence, and averting more deaths from the disease.
A colposcopy is used to examine the vulva, vagina, and cervix. A colposcopy is done after an abnormal Pap test or a positive HPV test suggests a precancerous condition of the cervix or cervical cancer. A colposcopy may also be done if you have symptoms of cervical cancer.
If a Pap test returns abnormal results, a biopsy from the cervix is taken. Further CT scan, MRI, and PET scan can also be done to check the cervix and area around the cervix. A PET scan is used to find cervical cancer that has come back or has spread to other organs or tissues.
Treatment:
Treatment of cervical dysplasia includes the loop electrosurgical procedure, cryotherapy (freezing of cervix), laser therapy (laser vaporization of the cervical epithelium), or conization (surgical removal of a cone-shaped specimen of the cervix with a surgical knife). Rarely hysterectomy is indicated for the management of cervical dysplasia.
Treatment of invasive cervical cancer can include surgery, radiation therapy, chemoradiation therapy, or chemotherapy, depending on clinical staging, and is based on the probability of locoregional control and systemic control.
Written by: Rubina Polara