Cervical screening helps in finding and treating early-stage cervical cancer. Doctors use two main tests to identify related viruses as well, as to detect changes in cervical cells.

Cervical cancer begins to develop in the narrow part of the uterus at its lower end, where it merges with the upper part of the vagina. Doctors find the human papillomavirus (HPV) in approximately 99% of cervical cancers. However, many HPV cases do not appear as cancerous. Having HPV is a very important risk factor for cervical cancer.

At the same time, pap smear testing and HPV testing are one of the main components of cervical cancer screening. According to the National Cancer Institute, regular screening reduces the risk of developing or dying of cervical cancer by 80%. In the United States, the number of deaths from cervical cancer has decreased by 2% thanks to tests and treatments in this area.

Screening tests

Cervical cancer screening involves the use of an HPV test or a pap smear test. Doctors may also perform a physical examination of the pelvis.

Pap smear

Healthcare professionals use a tool they call a speculum to gain access to the cervix and widen the vagina. A cell sample is then taken from the cervix. They send the cell sample to the laboratory for examination under a microscope. After going to the lab, lab technicians look at the appearance of the cells. If they have an abnormal appearance, it is possible to see the stages of development of cervical cancer, known as precancerous, early. Thanks to early treatment, changes in these cells can be corrected. Cervical cancer can be prevented before it starts.

HPV test

Doctors use HPV testing to detect many abnormal cellular changes that can lead to cervical cancer. At the same time, HPV DNA testing helps identify infections that experts don’t associate with cancer. A positive HPV test generally doesn’t mean a person will develop cancer.

Screening criteria and guidelines

There are certain guidelines for regular cervical cancer screenings. These guidelines may differ for each age range. All this information is included below.

21–29 years

A woman between the ages of 21 and 29 should have a pap smear test 3 years apart. At this stage, there is no need for HPV testing. At the same time, if the results are abnormal, doctors may also order a pap smear test with an HPV test. It was observed that 86.7% of people who tested positive for HPV did not develop cancer within 10 years. Pap smear age may also show differences.

30–65 years

Doctors recommend the following conditions, especially for people between the ages of 30 and 65. These:

• A common test or a combination of both tests should be done every 5 years.
• A pap smear test should be done every 3 years.

The American Cancer Society also warns that a combined HPV and Pap smear test can lead to more false positives and more tests.

Over 65 years

Women who have had regular screenings in the last 10 years and whose results are clear can usually stop screening at this age range. If there is a precancer finding in the tests performed within 20 years, the scans should be continued 20 years after this precancer finding.

Women with a high risk of cervical cancer

People with a high risk of cervical cancer should have more tests. It includes women who have HIV or have previously undergone organ transplants and women who have suppressed immune systems. People may also be at high risk if they are exposed.

After a total hysterectomy, which includes the removal of the uterus and cervix, it is no longer necessary to perform the scan. However, screening should continue if a hysterectomy has been performed by the doctor to treat cancer. Women who have had the HPV vaccine should undergo screenings.

People who already have or have previous uterine cancer and HIV infection also have their screening and treatment plans. Also, a false positive result will not only cause stress. It can also lead to unnecessary transactions that may have long-term risks. For this reason, doctors do not recommend screening annually.

Interpreting results

Cervical screening test results are examined in 3 different ways. These:

• Normal
• Ambiguous
• Abnormal

Normal: There are no changes in the cells of the cervix.

Uncertain: Cells appear to be abnormal. The pathologist was unable to determine the changes that would indicate a precursor to cancer. These abnormal cells may be a condition experienced by HPV, infection, pregnancy, or life changes.

Abnormal: It is the presence of changes in cervical cells by laboratory technicians. Abnormal cells don’t always show cancer literally. Doctors may often order more tests and treatments from you to see if the changes have become cancerous.

As an uncertain result, cell changes can occur. However, the cells are much closer to normal and will improve without the need for treatment. In this case, your doctor may ask you to test again within 6 months.

Usually, people of a younger age are more susceptible to low-grade squamous intraepithelial lesions that improve without treatment. Cervical erosion, which doctors sometimes refer to as ectropion, can also lead to vague results. Cervical erosion means that cells of the underlying glands can be seen on the surface of the cervix.

Erosions are more common in young people, especially in people who use birth control pills, and in people who are pregnant. There is also likely to be light bleeding after sexual intercourse. Many cases of erosion improve without treatment.

What to do after abnormal results?

When abnormal results are obtained in cervical cancer screenings (smear test or HPV test), colposcopy is usually recommended. Colposcopy is a procedure used to examine the cervix more closely.

Colposcopy is especially important for the diagnosis and early treatment of precancerous lesions. This procedure helps to determine the risk of cancer formation and establish a treatment plan by examining abnormal cells or tissues in the cervix region more closely.

Colposcopy is also used if a biopsy is necessary. Biopsy involves taking abnormal cells for examination in a laboratory. This enables the determination of the severity of precancerous lesions and the presence of cancer cells if any.

Abnormal smear test results can often be seen even in the absence of cervical cancer or precancerous lesions. However, performing colposcopy enables the screening results to be examined in more detail and facilitates the early diagnosis of potential health problems.

Test problems

Both standards, the cervical screening test, are generally reliable. However, although effective, it can also give unclear and abnormal results. These problems may occur in many examinations due to the presence of changing cells. People may have to repeat the test because of an insufficient sample. This means that the results are not conclusive. Causes of under-received sample:

• Very few cells in the test
• The presence of an infection that hides cells
• Menstruation and the fact that this makes it difficult for the cells to view
• Inflammation of the cervix, which can block the visibility of cells

People who want to have cervical cancer screening should first take precautions to manage infections and inflammation in the cervix.