LABORATORY TESTS RELATED TO CERVICAL DISEASES AND CANCER SCREENING
The goal of routine pelvic examination is to find cervical diseases, pre-cancer, or cancer early when it is more easily treatable. Regular cervical cancer screening (part of the routine pelvic exam) is highly effective at preventing cervical cancer and saving lives. Most healthcare providers recommend cervical cancer screening for all people with a cervix starting at age 21 and continuing until they are 65 (if there is no history of abnormal screening results). The screening process involves your healthcare provider taking a sample of cells from the cervix during a pelvic examination. The types of tests that may be performed include:
PAP TEST: This is the most common test used to detect cervical cancer and its precursors. Sometimes, it is called a Pap smear. The sample for this test is collected during a cervical examination at a doctor’s office. These tests are usually performed by a gynecologist. They will use a device called a speculum to open the patient’s vagina to see the cervix. Then they will use a small brush to collect cells from the surface of the cervix. These cells are sent to the lab, where a cytologist will use a microscope to look for any abnormal cells. If abnormal cells are discovered, the slide is reviewed by a pathologist who makes the diagnosis.
This screening test is important because it can detect growths that can turn into cancer even when physical symptoms are absent. Pap test results will be either “normal” or “abnormal.” Normal results mean the sample only contained normal cervical cells and there is no need for additional testing. Abnormal results mean there were abnormal cells found in the sample. Abnormal results do not mean the patient has cancer. Patients with abnormal Pap test results will need to get additional testing.
Guidelines recommend that a Pap test is conducted at least every 3-5 years, unless there is an increase in risk of cervical cancer due to presence of high-risk HPV, previous abnormal Pap tests, or other personal or family health history.
HUMAN PAPILLOMAVIRUS (HPV) TEST: This test screens for the presence of a high-risk HPV virus but it cannot detect cervical cancer. Like a Pap test, the test sample is collected during an in-office exam by a doctor using a small brush. The sample is sent to a lab, where a laboratory scientist checks it for the presence of genetic material from certain high-risk types of HPV. If the result is positive, the patient will need a Pap test to determine whether HPV has caused precancerous changes in the cells of the cervix.
HPV + PAP (CO-TESTING): This process uses the same sample for both a Pap test and an HPV test. Co-testing increases the chances of finding abnormal cells, cervical disease, or predicting the severity of cervical disease, and is the most sensitive method for cervical cancer detection.