Cervical cancer is one of the most important cancers which not only can be detected early but also prevented by a simple screening test called the Pap test.

The cervix develops cancer in a slow prolonged manner; usually 10-20 years from the first changes until cancer develops. The changes that occur are called metaplasia and then these may slowly progress to dysplasia and neoplasia. HPV (Human Papilloma Virus) which spreads by sexual contact is a common cause of cervical cancer. HPV can also cause Genital Warts. These changes may occur relatively soon after infection or may not occur for many years.

All women, who are sexually active or over 21 years of age, should have a Pap smear.

A Pap smear is obtained by scraping the cervix with a wooden stick and a tiny brush. The stick and brush pick up cells that are shed from the cervix. These cells are transferred to a glass slide by sweeping the brush and the stick on the slide. The slide is then fixed and sent to the laboratory where it is first stained with special dyes and then examined through the microscope. The smear is then reported. The report may be any of the following.

- No Pathologic Change. (Normal)
- Inflammation. (Signs consistent with an infection)
- Atypical Squamous Cells of Undetermined Significance (ASCUS)
- Some squamous cells are present which aren't normal, but they may be due to inflammation [95-98%] or pre-malignant change[2-5%])
- Atypical Glandular Cells of Undetermined Significance (AGCUS)
- Some glandular cells are present which aren't normal but they may be due to inflammation [80-85%] or pre-malignant change[1O-15%1)
- Low Grade Squamous Intraepithelial Lesion (LGSIL) (Some squamous cells are present which may come from an early pre-malignant lesion)
- High Grade Squamous Intraepithelial Lesion (HGSIL) (Some squamous cells are present which may come from an advanced pre-malignant lesion)
- Malignant cells are present. (Malignant squamous or glandular cells are present which may come from a cancer)

All of these, with the exception of numbers 1 and 2, require some kind of further evaluation. The further evaluation may be in the form of repeat smears, colposcopy, and biopsy. In this case one needs to consult the doctor with the report.

One can repeat the smear in 2-3 years time if the report is normal. It is recommended that one should continue to do the smears up to the age of 65. If last three smears at that age have been normal then further smears are not needed.

Therefore do a pap test if you have not already done one. It can prevent a deadly disease in the future. You can contact Dr Sangeeta Agrawal for a pap test and any further information.