CERVICAL CANCER SCREENING AND HPV
Human papilloma virus (HPV) is a microorganism that can cause warts in many parts of the body. It is the most common sexually transmitted disease. They have over 100 subtypes and are classified as high-risk and low-risk in terms of the possibility of cervical cancer. Although the main route of transmission is usually through direct sexual contact, it is rarely possible to pass through the joint use of personal belongings. Once infected, HPV can interact differently in the body.
First of all, after infection, it is substantially cleared by the body's immune system. Uncleaned HPV can go into sleep state, which we call latent period in the body, so the person can be carrier without any clinical findings. In addition, uncleaned HPV can cause warts in external reproductive organs. Finally, uncleaned HPV can cause pre-cancerous cervix formations and cervical cancer. Although the use of condoms for preservation is not highly successful because of skin contact, it has been shown to reduce contamination compared to never use. HPV vaccines are the most effective way of protection. The current vaccines include HPV types, most commonly causing cervical cancer and warts, and provide a high degree of protection against these types. The group with the best effect of the vaccine is individuals who have never had sexual contact before the vaccination.
The cervical cancer screening test, the pap smear test, is one of the most effective screening tests used in humans. Although the sensitivity is not very high, with repeated regular scans, the chance of catching cancer and pre-cancerous form increases. Pap smear test can be performed very easily in normal gynecological examination. It is based on the evaluation of the spilled cells from the cervix and cervical canal with the help of a brush or a special spatula and under the microscope by the pathologist. The purpose of the test is to screen for cancer or pre-cancerous formations in these spilled cells.
Pap smear test should be performed approximately 3 years after the first sexual intercourse and should not be later than 21 years old. For subsequent screening, it is appropriate to perform an annual smear test up to the age of 30 years. If there is no problem with the pap smear test 3 consecutive times after the age of 30, the test intervals can be reduced to 2-3 years. When the patient reaches 70 years of age and no problems are detected in at least 3 tests in the last 10 years, the patient can be removed from follow-up (if there is no known risk factor). Smear monitoring is not recommended if the patient's uterus has also been removed due to benign pathologies.
Pap smear screening should be recommended especially in those who have or had an HPV infection (eg, warts on the external reproductive organs) and the frequency of follow-up should be determined according to the type of HPV (high risk and low risk).