In this modern era, everything is advancing, even diseases. From regular coughs, which doesn't seem to be much of a big deal, to deadly pneumonia, asthma, and other respiratory diseases. As minor diseases develop stronger immunity against human immune system, new diseases strike humankind, one of the most commonly heard is probably cancer. Though it is curable during its early stages, it is still capable of taking lives silently without showing much symptoms during its early stages. There may be several methods and tests in spotting and preventing cancer, but one of the most successful test in detecting cancer is the Pap test.
Between 1955 and 1992, cervical cancer declined by 70%, and continued till 2003. This great success in detecting and preventing cervical cancer from spreading is all thanks to the Pap test.
The Pap test (Pap stands for Papanicolaou, originally came from the scientist who invented this test, Dr. George Nicholas Papanicolaou), also known as Papanicolaou smear or smear test, is a test that aims to detect signs of changes in the cavity of the cervix, which could either be precancerous or cancerous. In other words, it prevents cervical cancer from spreading out by detecting abnormalities during or before its early stages. (Martini, 2006, p. 114)
Cervical cancer, not to be confused with ovarian cancer, is a type of cancer that attacks the cervix, a lower portion of the vagina, that could invade or spread to other parts of the body (for example; ovary). This cancer may be completely free of symptoms during its early stages, but signs such as abnormal vaginal bleeding, pelvic pain, or pain during sexual intercouse could be some signs that the cancer is developing. This cancer is majorly caused by HPV (Human Papillomavirus) infections; however, not all HPV infections could lead to cancer, but in some cases, the infection may naturally go away and form genital warts in the future. Cervical cancer is 100% curable when it is still in its early stages, thanks to Pap test. (Tortora, and Grabowski, 2003, p. 1054)
The Pap test usually does not take much time, because the procedures are quite simple. Before taking the test, patients are strongly advised not to douche, do sexual intercourse, or take vaginal medications one or two days before taking the test. Firstly, the doctor will slowly insert an instrument, called speculum, that will open the vagina walls to allow access to the cervix. At this point of the test, patients might feel a minor discomfort, some might even feel a slight pain. Then, the doctor will take a few cell samples from the cervix, which will be taken to the lab for further inspection, with a spatula. After the test, patients might feel a mild pain in the uterine area, and light vaginal bleeding might immediately happen after the test. (DeMay, 2005, p. 196-199)
There are 2 results in this test, either normal or abnormal results. Normal result, usually said as "negative", means that there were no abnormal cell growth present. In some small cases, presence of abnormality was missed during inspection, but the follow-up test should be able to detect it. Abnormal result, usually said as "positive", means there is a presence of abnormal cell growth. It is grouped into 5; ASCUS, LSIL or HSIL, CIS, ASC, and AGC. (DeMay, 2005, p. 200-201)
Briefly, ASCUS (Atypical Squamous Cells of Undetermined Significance) result means there are changes, but it remains unclear what the changes mean, it might be caused by HPV, and may lead to cancer. LSIL (Low-grade Dysplasia) or HSIL (High-grade Dysplasia) means abnormal cell growth are present. Compared to LSIL, HSIL shows a greater risk of abnormality. CIS (Carcinoma In Situ) means the changes are most likely to lead to cervical cancer if left untreated. ASC (Atypical Squamous Cells) means abnormal changes are detected and mostly likely might be HSIL. AGC (Atypical Glandular Cells) means the precancerous cells are seen in the upper parts of the cervical area. (DeMay, 2005, p. 200-201)
Although the Pap test is reliable in detecting precancerous and cancerous cells in the cervix, it has its limitations too. Firstly, it is not 100% accurate, because the sample taken is just one small part of the cervix, which means the other parts might have cancerous cells. This is why it is advised to have regular tests, usually every two years if the results are negative (for minor changes, it is advised to take another test in 6-12 months). Not to mention, unsatisfied tests usually occured when blood, mucus, or vaginal bacterias are found present on the sample, making the cells hard to see. It is also strongly suggested that patients take the Pap test until they are 65 years old and has 2 or 3 negative results, this is advised because one Pap test does not stop the precancerous and cancerous cells from developing. Besides, not all part of the cervix was inspected during the test, like previously said, which means there is a possibility that the other area of the cervix might have abnormalities. (DeMay, 2005, p. 203-211)
One study shows that sampling error by clinician is responsible for 62% of false negative smears, while interpretive error by pathologists is responsible for 22%, and screening errors by cytotechnicians accounted for 16%. The reason why such error occurs is because, in order for the samples to be perfectly analyzed, it must be adequately collected, the slide must be closely monitored for abnormalities, and they must be appropriately interpreted. Deficiency in any of these steps could lead to a false negative result. Sometimes, the abnormal cells are missed under the microscope, and some abnormalities occurs in areas that are not always possible to get as samples, for example; the glands of the cervix. (DeMay, 2005, p. 203-211)
Not only human (clinicians, pathologists, etc.) errors, but the patients' decision and personality might also affect their chances in earlier prevention of cervical cancer. For some women, having their vaginas shown might be embarassing and uncomfortable, (especially when the doctor is a guy) which could back them off from taking the test for earlier prevention. This is pretty understandable and most of these types of women are advised to find a reliable and trusted doctor. All in all, the Pap test has shown great success in detecting precancerous and cancerous cells in cervix. Although some minor discomforts might be a problem for some, it is still advisable for women aged 21 and above to take the test regularly, for the sake of preventing cervical cancer development and maintaining a healthy body. I know I might not be a doctor, but what my motive in sharing this is to inform women out there to be more cautious and aware of their health.
Between 1955 and 1992, cervical cancer declined by 70%, and continued till 2003. This great success in detecting and preventing cervical cancer from spreading is all thanks to the Pap test.
The Pap test (Pap stands for Papanicolaou, originally came from the scientist who invented this test, Dr. George Nicholas Papanicolaou), also known as Papanicolaou smear or smear test, is a test that aims to detect signs of changes in the cavity of the cervix, which could either be precancerous or cancerous. In other words, it prevents cervical cancer from spreading out by detecting abnormalities during or before its early stages. (Martini, 2006, p. 114)
Cervical cancer, not to be confused with ovarian cancer, is a type of cancer that attacks the cervix, a lower portion of the vagina, that could invade or spread to other parts of the body (for example; ovary). This cancer may be completely free of symptoms during its early stages, but signs such as abnormal vaginal bleeding, pelvic pain, or pain during sexual intercouse could be some signs that the cancer is developing. This cancer is majorly caused by HPV (Human Papillomavirus) infections; however, not all HPV infections could lead to cancer, but in some cases, the infection may naturally go away and form genital warts in the future. Cervical cancer is 100% curable when it is still in its early stages, thanks to Pap test. (Tortora, and Grabowski, 2003, p. 1054)
The Pap test usually does not take much time, because the procedures are quite simple. Before taking the test, patients are strongly advised not to douche, do sexual intercourse, or take vaginal medications one or two days before taking the test. Firstly, the doctor will slowly insert an instrument, called speculum, that will open the vagina walls to allow access to the cervix. At this point of the test, patients might feel a minor discomfort, some might even feel a slight pain. Then, the doctor will take a few cell samples from the cervix, which will be taken to the lab for further inspection, with a spatula. After the test, patients might feel a mild pain in the uterine area, and light vaginal bleeding might immediately happen after the test. (DeMay, 2005, p. 196-199)
There are 2 results in this test, either normal or abnormal results. Normal result, usually said as "negative", means that there were no abnormal cell growth present. In some small cases, presence of abnormality was missed during inspection, but the follow-up test should be able to detect it. Abnormal result, usually said as "positive", means there is a presence of abnormal cell growth. It is grouped into 5; ASCUS, LSIL or HSIL, CIS, ASC, and AGC. (DeMay, 2005, p. 200-201)
Briefly, ASCUS (Atypical Squamous Cells of Undetermined Significance) result means there are changes, but it remains unclear what the changes mean, it might be caused by HPV, and may lead to cancer. LSIL (Low-grade Dysplasia) or HSIL (High-grade Dysplasia) means abnormal cell growth are present. Compared to LSIL, HSIL shows a greater risk of abnormality. CIS (Carcinoma In Situ) means the changes are most likely to lead to cervical cancer if left untreated. ASC (Atypical Squamous Cells) means abnormal changes are detected and mostly likely might be HSIL. AGC (Atypical Glandular Cells) means the precancerous cells are seen in the upper parts of the cervical area. (DeMay, 2005, p. 200-201)
Although the Pap test is reliable in detecting precancerous and cancerous cells in the cervix, it has its limitations too. Firstly, it is not 100% accurate, because the sample taken is just one small part of the cervix, which means the other parts might have cancerous cells. This is why it is advised to have regular tests, usually every two years if the results are negative (for minor changes, it is advised to take another test in 6-12 months). Not to mention, unsatisfied tests usually occured when blood, mucus, or vaginal bacterias are found present on the sample, making the cells hard to see. It is also strongly suggested that patients take the Pap test until they are 65 years old and has 2 or 3 negative results, this is advised because one Pap test does not stop the precancerous and cancerous cells from developing. Besides, not all part of the cervix was inspected during the test, like previously said, which means there is a possibility that the other area of the cervix might have abnormalities. (DeMay, 2005, p. 203-211)
One study shows that sampling error by clinician is responsible for 62% of false negative smears, while interpretive error by pathologists is responsible for 22%, and screening errors by cytotechnicians accounted for 16%. The reason why such error occurs is because, in order for the samples to be perfectly analyzed, it must be adequately collected, the slide must be closely monitored for abnormalities, and they must be appropriately interpreted. Deficiency in any of these steps could lead to a false negative result. Sometimes, the abnormal cells are missed under the microscope, and some abnormalities occurs in areas that are not always possible to get as samples, for example; the glands of the cervix. (DeMay, 2005, p. 203-211)
Not only human (clinicians, pathologists, etc.) errors, but the patients' decision and personality might also affect their chances in earlier prevention of cervical cancer. For some women, having their vaginas shown might be embarassing and uncomfortable, (especially when the doctor is a guy) which could back them off from taking the test for earlier prevention. This is pretty understandable and most of these types of women are advised to find a reliable and trusted doctor. All in all, the Pap test has shown great success in detecting precancerous and cancerous cells in cervix. Although some minor discomforts might be a problem for some, it is still advisable for women aged 21 and above to take the test regularly, for the sake of preventing cervical cancer development and maintaining a healthy body. I know I might not be a doctor, but what my motive in sharing this is to inform women out there to be more cautious and aware of their health.
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