Abnormal Cervical Screening

Cervical screening test (CST), previously known as PAP smear is a test looking for the presence of human papilloma virus (HPV) and /or changes in the cells of the cervix.

An abnormal CST can be concerning, but understanding what they mean is the first step towards effective management.

Cause of Cervical Abnormalities

The primary cause of cervical abnormalities is persistent infection with high-risk HPV strains.

HPV is of a very common skin virus in the sexually active population and is usually cleared from the body by your immune system within 3-5 years. Sometimes if HPV infection is persistent, it can cause cell changes that can lead to cancer in the future if left untreated. The process where cell changes develop into cancer is very slow and can take years to happen. Usually the HPV virus is cleared before the cells develop into cancer.

Symptoms & Diagnosis

In its early stages, cervical abnormalities typically do not present any symptoms. This asymptomatic nature underscores the importance of regular cervical screening tests. When advanced, symptoms may include abnormal vaginal bleeding, pelvic pain, pain during intercourse, and unusual discharge.

Diagnosis of cervical abnormalities is primarily achieved through cervical screening tests (CST), which can identify presence of HPV infection and /or abnormal cervical cells. The point of cervical screening program is to continue monitoring while HPV is present to monitor for the abnormal cell changes. To further investigate for abnormal cell changes, a colposcopy examination can be done in the clinic. If abnormal cell changes are confirmed, it can be treated before it has a chance to develop into cancer, thus preventing cervical cancer altogether.

Treatment Options

The treatment for cervical abnormalities depends on several factors, including the severity of the abnormality, the presence of HPV, age, and desire to preserve fertility. Options include:

  • Observation / Watchful Waiting: For minor changes that might return to normal on their own. This is appropriate for low grade cervical cell abnormalities., Living a healthy lifestyle and stopping smoking and other factors that may impair the immune system can facilitate a faster clearance of the HPV infection from the system.
  • Cervical Procedures: For more significant abnormalities, treatments may involve removing or destroying the abnormal cervical tissue. Methods include:
    • Cryotherapy: freezing off abnormal cells with liquid nitrogen.
    • Large loop excision of the transformation zone (LLETZ): this involves removing abnormal tissue using a thin, low-voltage electrified wire loop.
    • Cold knife cone biopsy: a method to extract a cone-shaped piece of tissue from the cervix for examination.
    • Laser therapy: using a laser to burn away abnormal cells.
  • Surgery: In cases where significant pre-cancerous cells are found or for early-stage cervical cancer, more extensive surgical procedures may be necessary.
  • HPV Vaccination: While not a treatment for existing abnormalities, the HPV vaccine can prevents some HPV infections.

Prevention & Awareness

Prevention of cervical abnormalities primarily revolves around regular screening and HPV vaccination. The Australian government recommends that all women aged 25 to 74 years participate in the National Cervical Screening Program by undergoing routine screening with HPV test every five years. The HPV vaccination is offered free to students in the first years of high school under the National Immunisation Program.

Educating the public about the importance of these preventive measures, alongside promoting safe sexual practices, can further reduce the incidence of HPV infections and subsequent cervical abnormalities. Healthcare providers play a pivotal role in raising awareness and encouraging participation in screening and vaccination programs.

dr_alice_huang_fertility_02

Living with Cervical Abnormalities

Receiving a diagnosis of cervical abnormalities can be distressing, but it is important to remember that early detection and treatment can lead to excellent outcomes. Regular follow-up, adherence to treatment plans, and lifestyle adjustments can help manage or resolve cervical abnormalities.

Conclusion

Understanding cervical abnormalities is the first step toward prevention and early intervention.

With advancements in screening and treatment, along with the availability of the HPV vaccine, the outlook for women with cervical abnormalities is more hopeful than ever. Regular screenings and awareness of cervical health are key components in reducing the risk of cervical cancer and ensuring a healthy reproductive system.

START YOUR JOURNEY

Compassionate, Holistic care and treatment.

Contact us today to schedule a consultation and take the first step towards realising your parenthood goals.