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Cervical cancer starts in the cells of the cervix, the lower narrow end of the
uterus opening into the vagina. Screening looks for cancer **before there are
any symptoms**.
The reason it works is timing. Cervical cancer usually develops slowly.
Before cervical cells become cancer they start to look abnormal — these are
precancers — and if they are not destroyed or removed they may become
cancer cells that grow out of control and spread. Screening finds the abnormal
cells while treatment can still prevent the cancer, and finds cancer early when
it is usually easier to treat.
The three tests
All use a sample of cervical cells collected with a swab, usually during a
pelvic exam at a routine checkup:
| Test | What it looks for |
|---|---|
| Pap test (Pap smear, cervical cytology) | Abnormal cells, so they can be treated before they become cancer |
| HPV test | Certain high-risk HPV infections — the types of human papillomavirus that cause cancer |
| HPV/Pap cotest | Both at once: high-risk HPV and cervical cell changes |
Abnormal results may lead to further tests, such as a biopsy.
When to start, and how often
If you have a cervix: a first Pap smear at 21, and HPV testing from 25.
How often after that depends on your age and health history, so it is a
conversation with your provider.
More frequent screening may be needed if you:
- Had an abnormal HPV test, Pap smear or cervical biopsy recently
- Have had a diagnosis of cervical cancer
- Have a weakened immune system
- Were exposed to DES (diethylstilbestrol) before you were born — it was
sometimes prescribed between 1940 and 1971 to prevent miscarriages
Over 65, with a history of regular Pap screening and normal results, your
provider may tell you screening is no longer needed.
Benefits and harms, both stated
Cervical cancer screening saves lives. Detecting changes early lowers the
chance of dying from cervical cancer.
It also has potential harms, and they are not symmetrical:
- A false positive — results look abnormal with no precancerous or
cancerous cells present. This means worry while further tests are done, and
possibly follow-up tests or treatment that was not needed. - A false negative — results look normal while precancer or cancer is
present. **This may lead you to delay seeking treatment even if you have
symptoms.**
The second is the one to hold on to. A normal screening result is not a reason
to ignore a symptom that appears afterwards.
Source: MedlinePlus, U.S. National Library of Medicine.
Licence : CC0 1.0 (domaine public) · Adapté de medlineplus.gov
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