Each year, more and more women are diagnosed with cancer of the cervix (cervical cancer) yet it is one of the most preventable cancers in the current modern world. Early detection and treatment of abnormal cell changes that happen in the cervix long before the development of cervical cancer can help prevent the cervix from the full development of cancer. Visit our doctors, the best pap smear specialists in New York City for the same-day appointment for Pap Smear or HPV test, the gold standard in cervical cancer screening.
This abnormal change of cells is caused by the human papillomavirus (HPV). The most common test done to detect HPV has always been the Pap test but for women who are aged 30 and above, an HPV test has to be done. HPV tests are able to detect any type of HPV including the ones that are considered to be of high risk of causing cervical cancer.
Recently, cancer experts in collaboration with the relevant authorities have approved one HPV test to be used primarily for screening cervical cancer in women aged 25 years and older, which may be followed by a Pap test for women who will show certain distinct results.
Currently, the guidelines set for screening cervical cancer state that women should start getting screened right from the age of 21 and that screening is not recommended for women who are under the age of 21.
Women who are 30 and above have three screening options available for them:
- both a Pap and HPV test every five years
- a Pap test alone every three years
- an HPV test only every five years.
If you are over 30 yo please visit our gynecology center in Midtown and on Manhattan’s Upper East Side for a pap test. Dr. Mariz at the Manhattan Gynecology offers accurate diagnostics and fast results.
The aim of performing a Pap test is to detect any abnormal changes in the cells of the cervix. When a woman is undergoing a Pap test, she is positioned on an examination table and a device known as a speculum is inserted into the vagina gently.
The speculum enables the medic to have a good view of the upper vagina and cervix. Once the cervix is clearly visible to the medic, a brush-like spatula is used to collect a sample of the cells. For Dr. Mariz to be able to collect glandular and squamous cells, he will need to rotate the device in the cervical canal (endocervix) and also to the portion of the cervix that extends into the vagina (ectocervix). The cells collected are then taken to a laboratory where they are prepared and evaluated under a microscope.
If the Pap test results identify any signs of abnormality or precancerous changes, the patient is termed to have cervical dysplasia.
Other terms commonly used by medics to refer to this condition include:
- Cervical Intraepithelial Neoplasia (CIN)
- Squamous Intraepithelial Lesions (SIL)
- Precancerous cell changes
- Abnormal cell changes
All of these terminologies mean that abnormalities have been found. Most of these abnormalities usually happen due to the presence of HPV. There are various types of HPV that are responsible for causing cervical dysplasia, and most of them are considered to be ‘high-risk’ types meaning that they have a high chance of causing cervical cancer.
Cervical dysplasia doesn’t automatically mean that a woman will get cervical cancer. It means that her cervix needs to be closely monitored more often while receiving treatment to prevent further changes in the cells that may get out of control and become cancerous.
To find any high-risk types of HPV that are commonly found in cervical cancer, HPV testing is preferred. Any type of HPV present in the cervix for a long period of time can cause cell changes and needs to be managed promptly to avoid the occurrence of cervical cancer. The HPV test is normally done at the same time as the Pap test by the use of a small soft brush to collect a sample of cervical cells that are then taken to the laboratory.
About 70% of all cervical cancers worldwide are caused by two ‘high risk’ HPV types (HPV 16 and HPV 18) also known as genotypes. It is very important for a healthcare provider to know whether the patient she is dealing with might have any of these types of high-risk HPV. This prior knowledge gives the healthcare provider more insight into the heightened risk his/her patient is facing toward developing cervical cancer.
Another recently approved test known as ‘cobas’ is available for women aged 25 and above as a primary method of screening cervical cancer. This test can be done alone without a Pap test, but for women who show certain suspicious results, a pap test should also be done. Women are advised not to worry so much about which method of screening is best for them but rather get regular screenings because the exact tests are done are not as important as being screened regularly.
Getting ready for a Pap and/or HPV Test in Midtown, Manhattan
To ensure that you get the best results possible from an HPV or Pap test, there are several steps you can take:
- Avoiding sexual intercourse 2 days (48hrs) before the test
- Schedule the test on a day when you are not on your menstrual cycle
- Avoid taking a shower 48 hours before the test
- Avoid the use of tampons, vaginal creams, films, foams or any vaginal pessaries inserted into the vaginal canal for at least 48 hours before the test.
There are various systems that medics use to classify a Pap test. Within each system, there are different levels of severity or abnormalities.
These classification systems and degrees of severity include:
- Descriptive system – mild dysplasia, moderate dysplasia, and severe dysplasia.
- CIN system – CIN stands for Cervical Intraepithelial Neoplasia and the results are classified as CIN 1, CIN 2 and CIN 3.
- Bethesda system:
- Atypical Squamous Cells of Undetermined Significance (ASC-US). This means that the results are borderline between ‘normal’ and ‘abnormal’ and are often not related to HPV.
- Atypical Squamous Cells-cannot excludes HSIL (ASC-H). Also, it means that the results are on a borderline but may include high-grade lesions.
- Low-Grade SIL (LSIL) and high-grade SIL (HSIL). SIL is an abbreviation for Squamous Intraepithelial Lesion. LSILs are known to be mild abnormalities caused by an HPV infection. HSILs are more severe abnormalities that have a high chance of advancing to invasive cancer.