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Theme Cer­vi­cal Can­cer & Pap Smear : The Sav­ing Grace

● Overview
This can­cer can often be found ear­ly, and some­times even pre­vent­ed entire­ly, by hav­ing reg­u­lar Pap tests. It is very impor­tant for to note, if detect­ed ear­ly, cer­vi­cal can­cer is one of the most suc­cess­ful­ly treat­able can­cers.
● What’s is can­cer ?
Can­cer starts when cells in the body begin to grow out of control.Cells in near­ly any part of the body can become can­cer, and can spread to oth­er areas of the body.
● What Is Cer­vi­cal Can­cer?
Cer­vi­cal can­cer starts in the cells lin­ing the cervix (the cervix is the low­er part of the uterus (womb). This is some­times called the uter­ine cervix.The fetus (baby) grows in the body of the uterus (the upper part).
The cervix con­nects the body of the uterus to the vagi­na (birth canal) as is depict­ed in the pic­ture. The part of the cervix clos­est to the body of the uterus is called the endo­cervix. The part next to the vagi­na is the exo­cervix (or ecto­cervix).
There are 2 main types of cells cov­er­ing the cervix. These 2 cell types meet at a place called the trans­for­ma­tion zone. The exact loca­tion of the trans­for­ma­tion zone changes as you age and if you give birth.
Most cer­vi­cal can­cers begin in the cells in the so called trans­for­ma­tion zone.These cells do not sud­den­ly change into can­cer. Instead, the nor­mal cells of the cervix first grad­u­al­ly devel­op pre-can­cer­ous changes that turn into can­cer lat­er.
Nor­mal­ly, doc­tors use sev­er­al terms to describe these pre-can­cer­ous changes, includ­ing cer­vi­cal intraep­ithe­lial neo­pla­sia (CIN),squamous intraep­ithe­lial lesion (SIL), and dys­pla­sia.
These changes are the basis for the pap smear test.These changes can be detect­ed ear­ly by rou­tine Pap test and treat­ed to pre­vent can­cer from devel­op­ing.
● His­tor­i­cal Back­ground
Cer­vi­cal can­cer used to be a very dead­ly scourge. It was once one of the most com­mon caus­es of can­cer death for Amer­i­can women.
But over the last 30 years, the cer­vi­cal can­cer death rate has gone down by more than 50%. The main rea­son for this change was the increased use of the Pap test.
This screen­ing pro­ce­dure can find changes in the cervix before can­cer devel­ops. It can also find cer­vi­cal can­cer ear­ly in its most cur­able stage. Nor­mal­ly, cer­vi­cal can­cer tends to occur in midlife. Most cas­es are found in women younger than 50.It rarely devel­ops in women younger than 20, but can devel­op.
Many old­er women do not real­ize that the risk of devel­op­ing cer­vi­cal can­cer is still present as they age.
More than 15% of cas­es of cer­vi­cal can­cer are found in women over 65. So, it is still a huge sig­nif­i­cant con­cern at this age.However these can­cers rarely occur in women who have been get­ting reg­u­lar tests to screen for cer­vi­cal can­cer before they were 65.
● Signs and symp­toms of cer­vi­cal can­cer
Most women with ear­ly cer­vi­cal can­cers and pre-can­cers usu­al­ly have no symp­toms. Symp­toms often do not begin until a pre-can­cer becomes a true inva­sive can­cer and grows into near­by tis­sue. When this hap­pens, the most com­mon symp­toms are:


● What’s is can­cer ?
Can­cer starts when cells in the body begin to grow out of control.Cells in near­ly any part of the body can become can­cer, and can spread to oth­er areas of the body.
● What Is Cer­vi­cal Can­cer?
Cer­vi­cal can­cer starts in the cells lin­ing the cervix (the cervix is the low­er part of the uterus (womb). This is some­times called the uter­ine cervix.The fetus (baby) grows in the body of the uterus (the upper part).
The cervix con­nects the body of the uterus to the vagi­na (birth canal) as is depict­ed in the pic­ture. The part of the cervix clos­est to the body of the uterus is called the endo­cervix. The part next to the vagi­na is the exo­cervix (or ecto­cervix).
There are 2 main types of cells cov­er­ing the cervix. These 2 cell types meet at a place called the trans­for­ma­tion zone. The exact loca­tion of the trans­for­ma­tion zone changes as you age and if you give birth.
Most cer­vi­cal can­cers begin in the cells in the so called trans­for­ma­tion zone.These cells do not sud­den­ly change into can­cer. Instead, the nor­mal cells of the cervix first grad­u­al­ly devel­op pre-can­cer­ous changes that turn into can­cer lat­er.
Nor­mal­ly, doc­tors use sev­er­al terms to describe these pre-can­cer­ous changes, includ­ing cer­vi­cal intraep­ithe­lial neo­pla­sia (CIN),squamous intraep­ithe­lial lesion (SIL), and dys­pla­sia.
These changes are the basis for the pap smear test.These changes can be detect­ed ear­ly by rou­tine Pap test and treat­ed to pre­vent can­cer from devel­op­ing.
● His­tor­i­cal Back­ground
Cer­vi­cal can­cer used to be a very dead­ly scourge. It was once one of the most com­mon caus­es of can­cer death for Amer­i­can women.
But over the last 30 years, the cer­vi­cal can­cer death rate has gone down by more than 50%. The main rea­son for this change was the increased use of the Pap test.
This screen­ing pro­ce­dure can find changes in the cervix before can­cer devel­ops. It can also find cer­vi­cal can­cer ear­ly in its most cur­able stage. Nor­mal­ly, cer­vi­cal can­cer tends to occur in midlife. Most cas­es are found in women younger than 50.It rarely devel­ops in women younger than 20, but can devel­op.
Many old­er women do not real­ize that the risk of devel­op­ing cer­vi­cal can­cer is still present as they age.
More than 15% of cas­es of cer­vi­cal can­cer are found in women over 65. So, it is still a huge sig­nif­i­cant con­cern at this age.However these can­cers rarely occur in women who have been get­ting reg­u­lar tests to screen for cer­vi­cal can­cer before they were 65.
● Signs and symp­toms of cer­vi­cal can­cer
Most women with ear­ly cer­vi­cal can­cers and pre-can­cers usu­al­ly have no symp­toms. Symp­toms often do not begin until a pre-can­cer becomes a true inva­sive can­cer and grows into near­by tis­sue. When this hap­pens, the most com­mon symp­toms are:

  1. Abnor­mal vagi­nal bleed­ing, such as bleed­ing after sex (vagi­nal inter­course), bleed­ing after menopause, bleed­ing and spot­ting between peri­ods, and hav­ing longer or heav­ier (men­stru­al) peri­ods than usu­al. Bleed­ing after douch­ing, or after a pelvic exam is a com­mon symp­tom of cer­vi­cal can­cer but not pre-can­cer.
  2. An unusu­al dis­charge from the vagi­na − the dis­charge may con­tain some blood and may occur between your peri­ods or after menopause.
  3. Pain dur­ing sex (vagi­nal inter­course).
    PLEASE NOTE!
    These signs and symp­toms can also be caused by con­di­tions oth­er than cer­vi­cal can­cer. For exam­ple, an infec­tion can cause pain or bleed­ing. Still, if you have any of these prob­lems, you should see your health care pro­fes­sion­al right away − even if you have been get­ting reg­u­lar Pap tests.
    If it is an infec­tion, it will need to be treat­ed. If it’s can­cer, ignor­ing symp­toms might allow it to progress to a more advanced stage and low­er your chance for effec­tive treatment.Even bet­ter, don’t wait for symp­toms to appear. Be screened reg­u­lar­ly.
    Ref­er­ences & Cita­tion
    ● Amer­i­can Can­cer Soci­ety

By Dr. Chu­di Ufon­du, MBBS,MPH, CPH

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