Understanding precancerous changes of the cervix

Understanding precancerous changes of the cervix

Cervical changes are common in women and can develop at any age but generally occur in women in their 20s and 30s.  The vast majority of these changes are considered precancerous conditions of the cervix.  Precancerous means these changes are not yet cancer but there is a higher chance these abnormal changes will become cervical cancer if they are not treated.  Here are some basic facts and what is known about cervical cell changes:

·      Cervical cell changes happen slowly.  It can take 10 years or longer for cells to develop into cervical cancer.

·      Nearly all cervical cancer is caused by a virus called HPV or human papillomavirus which is considered to be the main risk factor for precancerous changes in the cervix.

·      The best and most reliable tool all women should depend on using to detect cervical cancer is the Pap smear test and early HPV vaccination to prevent it.

·      Being told you have an abnormal test result does not mean you have cancer.  What it does mean is that cervical cell changes were found or that cells are infected with HPV.  Depending on the results, you may need follow-up testing or treatment. 

Pap Test and HPV Test

The Pap test and HPV test are screening tests for cervical cancer.  The purpose of screening tests is to check for disease before there are any symptoms.  Even if a woman feels fine, she still needs cervical cancer screenings.  By having these screenings done regularly, they can help find changes in cervical cells; if any changes are found, they can be treated promptly helping a woman stay healthy.

One of the best ways to prevent cervical cancer is to have regular Pap tests. The Pap test or Pap smear, helps find cervical cells changes that have the possibility of turning into cervical cancer.  This same test can also help find an infection or inflammation within the cervix not related to cancer.

The HPV test helps find infection with the different types of HPV that can cause cancer.

Pap test results

Once a Pap test is done, a woman will have to wait 1-3 week to get the results which will show if the cervical cells are normal or abnormal:

·      Normal Pap test results – If the test comes back normal, there were abnormalities detected within the cervical cells,

·      Unsatisfactory Pap test results – An unsatisfactory Pap test result could be due to the lab sample not having enough cells, or the cells may have been clumped together or hidden by blood or mucus.  Most likely a woman will need to come in for another Pap test.

·      Abnormal Pap test results – This is when the lab sample detected cervical cell changes.  They will be categorized from less serious to more serious.  These changes may be referred to as dysplasia, neoplasia, or precancer – cells that are abnormal but are not cancer.  An abnormal test result may also be called a positive test result.  It will be recommended for the woman to have more testing or treatment for these findings.

Testing and treating a precancerous change of the cervix

If a woman is told she has a precancerous change in the cervix, her doctor will recommend further testing.  The screening recommended depends on a number of factors including a woman’s age, menopausal status, Pap test results, and whether she is pregnant.  Follow-up testing may include one or more of the following:

·      Repeat Pap test – Some women may simply need another Pap test within a few months to see if the abnormality is still there.

·      HPV testing – Since many changes in the cervix are caused by an HPV infection, it may be recommended to have the cervical cells test for HPV. 

·      Colposcopy – This test allows the doctor to get a better look at the cervix through a magnifying device. 

·      Cervical biopsy – This involves removing a small sample of cervical tissue and sending it to a lab for testing.

·      Endometrial sampling – This involves taking a sample of the endometrium or uterine lining for study in a lab.

If the testing confirms a woman has a precancerous cervical lesion, there are treatments that can help reduce the chances the lesion will develop into cervical cancer.  These treatment options include the following:

·      Loop electrosurgical excision procedure (LEEP) – A thin, electrical charged wire is used to remove the abnormal cells from the cervix.

·      Freezing or cryotherapy – Some precancerous cells can be destroyed by freezing them with a cold probe which will cause them to be shed from the cervix.

·      Laser treatment – A beam of laser light is used to destroy the precancerous lesion

·      Conization – A small, cone-shaped piece of tissue containing the abnormal area of the cervix is removed surgically.