SMEAR TEST
Smear test is a special cervical screening test performed on women to evaluate the cervix and check it for both infections and cancer-precancerous conditions.
For what purpose is the smear test performed?
The most important purpose of this test is the early diagnosis of cervical cancers and precancerous lesions. In recent years, it has become a routine part of gynecological examination and gynecological controls.
How is the smear test done?
Due to the constant renewal of body tissues, cells inevitably shed from the surfaces. Collecting these shed cells and examining them under a microscope after special processing is called "cytological examination (cellular examination)". The area where the cytological examination procedure is most effectively applied is the samples taken from the cervix. The process of collecting cervical cells in this way is called "smear" (smear, swab).
Is taking a smear test a painful procedure?
The smear test is a part of normal gynecological examinations and you will never feel pain while the smear is taken during your gynecological examination.
What is the importance of the smear test?
Detecting a cancer before it occurs can almost only be achieved with a smear test in medicine.
Cervical cancer is the second most common cancer in the female reproductive system after breast cancer. It is a condition that results in complete cure when caught at an early stage.
As with all cancers, cervical cancer occurs after a period of latent disease that lasts for many years.
Unfortunately, the disease has spread after complaints of cervical cancer appear. That's why various tests have been developed to identify cancers at an early stage.
The most important test in the early diagnosis of cervical cancer is the smear test.
How to take a smear?
Taking a smear is extremely simple and painless. It is a method. During the gynecological examination, the cervix is made visible after a tool called "speculum" is inserted into the vagina. Afterwards, a swab is taken from the cervix using a smear brush. The brush tip is placed into the liquid material prepared for smear and sent to pathology. It is necessary to be careful?
The most important point to pay attention to when taking a smear is to take separate samples from the canal connecting the cervix to the uterine cavity and from the vagina.
Smear is a very effective screening method. In this way, abnormal cells are detected at very early stages and their progression towards advanced cancer can be prevented with appropriate treatment methods.
Smear test also provides information about the woman's hormonal status and infections, and also plays an important role in the early detection of recurrences after cancer treatment.
High risk group for cervical cancers:
Smokers
Polygamous (polygamous) women, OR women whose partners are polygamous
Those who had their first sexual experience at a young age
Those with Human Papilloma Virus (HPV) infection
FIRST SCREENING
At the beginning of sexual activity
Once a year in the high risk group
First 3 years in the low risk group once a year, then every 3 years.
Following cancer treatment, every 3 months for the first 2 years, every 6 months for 3 years, then annually
How is the reliability of the smear test?
The false negative rate in smear screening is approximately 25%. In other words, there is a 25% probability that the smear will be normal even though there is clinically malignancy (bad).
HPV DNA Test
Cervical cancer HPV (human papilloma) virus) relationship
What is HPV?
HPV is a non-enveloped DNA virus of which over 100 types have been identified. It is transmitted through sexual intercourse at a rate of over 99%. 40 of these affect the anogenital organs. 15-20 of them are high-risk oncogenic types. It is the most common sexually transmitted disease. Persistent HPV infection is the most important and strong risk factor for precancerous lesions of the cervix and cervical cancer.
How is HPV transmitted?
Nearly 100% of HPV infection occurs sexually. gets infected. It can also be transmitted through genital contact. Rarely, there are other routes of transmission; For example, if a mother infected with HPV gives birth, the baby may become infected. Recurrent Respiratory Papillomatosis (condylomatous lesions in the larynx) is a rare condition with a rate of 2 in 100,000. Lesions may appear within 2-3 months after contact with HPV. Eri An adult woman has an 80% chance of being infected with HPV by the time she reaches the age of 50.
What is the frequency of HPV DNA presence in cervical cancers and precancerous lesions?
At least one high-risk HPV DNA type is present in almost all cervical cancers.
High-risk HPV DNA can be detected in approximately 50% of ASC-US smear abnormalities, approximately 83% in LGSIL, and 90% in HGSIL.
Presence of HPV infection. How to understand?
HPV DNA tests can be used in some cases and high-risk types for cancer can be detected.
Who should we test?
HPV DNA tests are used in two situations today. :
1. Another option for patients whose smear results are ASC-US is the HPV DNA test.
2. HPV DNA test has been approved for use in patients over the age of 30 as an additional auxiliary test in addition to the smear test for cervical cancer screening.
Does HPV always cause cervical cancer?
No. HPV infections are often cleared by the body; HPV infection is completely cleared from the body within 1 year in 70% of patients and within 2 years in 90% of patients. In the remaining 10%, the disease persists and this group is the main risk group in terms of cancer development. The effect and duration of natural immunity after infection are not clearly known today.
How can we be protected?
Not engaging in sexual activity is the most definitive method of protection from HPV. Monogamy may reduce the risk. Barrier contraception methods such as condoms do not eliminate the risk of infection, but reduce it by 60%. The use of spermicidal gel may reduce the risk. HPV vaccines reduce the risk of developing and continuing infection by 91%-99%, respectively.
Can HPV infection be treated?
It is not possible to treat HPV infection itself, but If there are lesions caused by HPV infection, they can be treated with various methods. These lesions may appear as condylomas (warts) on the vulva (the skin organ covering the female genital organ) or as condylomas or pre-cancerous lesions on the cervix. These lesions can be removed by cauterization, cryotherapy (freezing), laser, LEEP, surgical excision (cutting out). ) or some creams (for condylomas).
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