CERVICAL CANCER SCREENING TESTS

SMEAR TEST

 

Smear test is the process of taking a swab from the cervix for cytological examination. This test is the most practical and best screening method to detect cellular changes that may turn into cervical cancer. Thus, it is possible to be protected from cervical cancer with early diagnosis.

 

Why is it done?

 

Smear test The purpose of doing this is to detect early some lesions in the cervix that are not cancerous but have the risk of turning into cancer after many years if not noticed. In this way, these lesions, which are detected early, are treated and eliminated before they turn into cancer.

 

How and When is it Done?

 

During the gynecological examination, a swab sample is taken from the cells of the cervix with a special swab. The procedure is performed in the gynecological examination position and on the gynecological examination table, just like an examination from below. An examination device (speculum) is inserted and a swab is taken from the cervix with a small stick. Removing a piece is not a process such as tearing off a piece, the rod is simply applied to the cervix. The patient does not feel pain when the smear is taken. The process takes approximately 1-2 minutes.

 

  PAP Smear:  After the cells in the swab are applied to the glass, they are fixed by spraying on them and It is sent to pathology for examination. Meanwhile, cells are crushed, folded, and may remain in blood, mucus and dark discharge. These are factors that limit / complicate the cytopathologist's microscopic examination. There is a 25% chance of giving incorrect results.

 

 Thinprep:  In this method, the swab taken with the swab is not applied to the glass. In this technique, after the sample is collected in a liquid, it is processed by the advanced automatic Thinprep 2000 processor, while blood, discharge and inflammatory cells are removed from the environment and the cytopathologist has the opportunity to examine only the cells shed from the cervix under the microscope. Studies have shown that this new method is 4 times more sensitive and gives more accurate results. The probability of giving false results is 4%.

 

Pre-test recommendations:

Before taking a smear. Sexual intercourse should not be had for the next 2 days. Vaginal medications, pessaries, suppositories, creams, sprays and tampons should not be used. Vaginal douche should not be performed, that is, the inside of the vagina should not be washed. A smear cannot be taken during menstruation. Blood prevents the evaluation of the smear.

 

CO-TEST:

 Smear test in cervical cancer screening and Performing and evaluating the HPV test at the same time is called cotest (pronounced "cotest"). HPV DNA test is also performed from the smear taken for smear; there is no need to take a separate swab or piece for HPV. Evaluation of both gives more reliable results than only smear evaluation, therefore, nowadays, screening with co-test is more recommended for women between the ages of 30-65 instead of only smear test (if there is an opportunity to perform HPV test). As a result of the co-test, the result of the smear test, that is, cytological evaluation and HPV test, is evaluated in combination. For example, abnormalities in the smear test and positive detection of high-risk HPV types indicate a high-risk situation and treatment is planned accordingly. However, if HPV DNA is not detected in a woman with an abnormal smear result, this indicates a much lower risk situation, and treatment or follow-up is planned in a more moderate manner. If both the smear and HPV DNA tests are normal, this indicates the most risk-free situation.


 

Who Should It Be Done?

 

* Smear test should start from the age of 21. For women who have not had sexual intercourse until the age of 21, smear tests begin after they start having sexual intercourse.
* For women who have had sexual intercourse before the age of 21, smear tests begin at the age of 21.
* It is recommended to perform a smear test every 3 years between the ages of 21-30.
* After the age of 30, smear test and HPV test are performed together (co-test). Co-testing should be done every 5 years from age 30 to age 65. If HPV testing is not possible, that is, if co-testing cannot be done, then only smear analysis continues to be performed every 3 years.
* People under 30 years of age should not be tested for HPV.

Uterine uterus surgery should not be performed. and the cervix Women who have had their breasts removed never need to have a smear taken after the surgery. In women with pathologies detected only in the cervix (cervix), such as CIN 2, CIN 3, HSIL, AIS, cervix cancer, smear follow-up is continued after the surgery. * In some cases, only the uterus is removed by surgery, but the cervix is ​​not removed. It is left without removal (supracervical hysterectomy, subtotal hysterectomy). In this case, since the cervix has stopped, smear follow-ups should continue in the same way. In this respect, it is important for patients who have undergone uterine surgery to receive clear information from their doctors about whether the cervix has been removed or not. If the patient exceeds the age of 65, follow-up is not terminated, follow-up continues until 20 years. Performing conventional or Thinprep does not change the test frequency

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