CANCER SCREENING TESTS
What are Cancer Screening Tests ?
Cancer screening tests are a series of tests that help identify various types of cancer before the symptoms start to show. This helps diagnose cancer at a very early stage when it is more likely to be completely treatable .The different cancers for which screening is routinely done are breast, cervix, endometrial cancer and colorectal cancer. The tests that are done, at what age the screening process starts, how often and for how long the screening continues depends on the patient’s personal, medical and family history.
BREAST CANCER DIAGNOSIS :
One of the most common tests employed for breast cancer diagnosis is mammogram. Routine yearly mammograms are recommended after the age of 45 till 54 years of age. Women older than 54 years can get them done every two years. Women should be familiar with the size and shape of their breast and nipples and the texture of the breast tissue, so that they can be aware of any changes and seek medical help at the earliest.
Though these are the general recommendations, it may vary based on the woman’s history. Woman who have a strong family history of breast or ovarian cancer or women who have a history of radiation treatment will need more extensive and more frequent cancer screening tests.
CERVICAL CANCER DIAGNOSIS :
In the early stages, cervical cancer is asymptomatic and at this stage it can be diagnosed by means of a test called Pap smear, which involves scraping the cells of the cervix and analyzing them for cancerous changes. Screening for cervical cancer usually starts at the age of 21.
RECOMMENDATIONS FOR CERVICAL CANCER SCREENINGS :
- Age 21 – 29 : Pap smear every three years.
- Age 30 – 65 : In this age group, it is recommended that the women be screened also for the HPV virus. Current recommendations, say to get a combined Pap smear and HPV test every 5 years. Another option for women in age group could be to just get pap smear every three years.
- Women over the age of 65 can stop the routine pap smears as long as they have had regular screenings done in the past and had normal results. However if they have had any abnormal results they will need to continue for longer.
- Some special circumstances include women who have had hysterectomies. In such cases if the hysterectomy also included removal of the cervix and the surgery was not for cervical cancer, then the screening can be stopped. However if the cervix was left behind during the surgery the screening needs to continue.
MYTHS ABOUT CERVICAL CANCER SCREENING
Some women believe, that they are immune to cervical cancer once they have children or once they get the HPV vaccine. This is not true, and they still need to continue with the screening.
Yearly Pap smear is not recommended, unless the doctor specifically asks for it based on a previously abnormal result.
Also these general guidelines may not apply to women who are HIV +ve or have had cervical cancer.
RISK FACTORS FOR CERVICAL CANCER :
- Family history of cervical cancer.
- Infection with the human papilloma virus.
- Patients with poor immunity such as HIV +ve women, post organ transplant or women who have auto immune illnesses.
- Chlamydia infection.
- Being overweight.
- Prolonged use of contraceptive pills.
- Younger than 17 years at first full term pregnancy.
PREPARATION FOR THE PROCEDURE
Pap smear is done as an OPD procedure and is painless and does not include any anesthetic. The best time to get a pap smear is few days after the menstrual period Patients would need to avoid the following at least 48 hours before the procedure. This is to increase the accuracy of the test.
- Sexual Intercourse
- Vaginal Medications (ask the doctor)
- Vaginal Contraceptives like birth control foams, creams etc.
It is a very short procedure. The patient will be asked to lie down with the knees bent and the heels resting in stirrups.
The doctor will insert the speculum into the patient’s vagina to hold the walls of the vagina apart. This will allow the doctor to get a better view of the cervix. The doctor will now take samples of the cervical cells by using a spatula, a scraping device. The patient usually doesn’t feel pain.
The doctor will now transfer the samples to be taken to a laboratory where they are examined to look for cell characteristics that indicate cancer or a pre-cancerous condition.