Cervical Cancer Screening and Diagnosis

The best thing you can do to reduce your risks of cervical cancer is to have a gynecologic exam performed by a healthcare professional every year. You also can also lower your risk by:

• Getting the HPV (human papillomavirus) vaccine
• Having a Pap test
• Using condoms
• Quitting smoking
• Limiting your number of sexual partners

With the HPV vaccine, which is approved for individuals age 9 to 45, routine Pap tests and HPV testing, we can prevent cervical cancer and dysplasia.

Cervical cancers and precancers are classified by how they appear under a microscope. The main types of cervical cancers are diagnosed as either squamous cell carcinoma or adenocarcinoma:

• Squamous cell cervical cancer develops in the lining of the cervix and is found in 80%-90% of cervical cancer cases.
• Adenocarcinoma develops in gland cells that produce cervical mucus. Approximately 10%-20% of cervical cancers are described as adenocarcinoma.

Less commonly, cervical cancer may have features of both squamous cell carcinoma and adenocarcinoma. This type of cervical cancer diagnosis is called adenosquamous carcinoma or mixed carcinoma. Other types of cancer also can develop in the cervix. These include melanoma, sarcoma and lymphoma, which occur more commonly in other parts of the body.

After we diagnose cervical cancer, additional testing can determine whether cancer cells have spread within the cervix or to other parts of your body. Information we gather from the staging process helps us determine the stage of your cancer, which is critical to planning appropriate cervical cancer treatment.

Cervical cancer stages are diagnosed by the presence and location of cancer cells:

• Stage 0: Called carcinoma in situ, stage 0 cervical cancer is diagnosed when the inner lining of the cervix shows abnormal cells. If not treated at this stage, these cells can become cancerous.
• Stage 1: Cancer cells are found only in the cervix.
• Stage 2: Cancer cells have spread past the cervix and into the uterus, but haven’t reached the pelvic wall or the lower third of the vagina.
• Stage 3: Cancer cells have spread to the pelvic wall or the lower third of the vagina. At stage 3, cervical cancer may affect kidney function.
• Stage 4: Cancer has spread to the bladder, rectum or other areas of the body beyond the pelvis.

Your chances of recovering from cervical cancer are best with early screening and diagnosis. Death from cervical cancer is nearly 100% preventable with routine examinations, including HPV screening and Pap tests.

HPV screening pinpoints the presence of high-risk HPV virus types in cervical cells. HPV infection can cause cell abnormalities, sometimes even before the abnormalities are visually evident.

The Pap test is a simple procedure done as part of your pelvic exam. During a Pap smear, a small sample of cells is collected from the cervix, transferred to a slide and viewed under a microscope.

Pap tests should be performed within 3 years after a woman begins having sexual intercourse or by age 21, usually annually. American Cancer Society guidelines suggest that some women can safely schedule Pap tests less often than every year. However, if you are at high risk, your doctor may perform cervical cancer screening exams more often than yearly. You should discuss this with your doctor.

If your Pap test shows abnormal cell growth, your doctor may recommend additional testing for an accurate diagnosis.