Detecting Abnormal Cells That Cause Cervical Cancer

Regular checks can detect abnormalities in cervical cells that have the potential to develop into cancer. Cervical cancer is a type of cancer in women that can be prevented by routine checks. The development of cervical cancer that starts from abnormal cells is a process that generally occurs without any symptoms. Most cases of cervical cancer only cause symptoms if the cancer has reached an advanced developmental stage. Therefore, the purpose of routine checks is to "catch" abnormal cells that have the potential to become cancerous or cervical cancer at an early stage.

Abnormal Pap Smear Results

Pap smear or liquid based cytology (LBC) is the most effective test for detecting cervical cancer. This test is recommended to be done once every three years for women aged 25-49 years and once every five years for women aged 50 years and over. Generally about 90% of the results of pap smears performed on women show normal results. Some other abnormal results related to changes in cervical cells, can be categorized as follows:

Mild change. Cells do not experience significant changes and can return to normal by itself. However, you are advised to undergo one of 2 alternatives:
• HPV virus test.
• Pap smears every six months 2-3 times, to ensure cells have returned to normal.
If the HPV virus is detected or the following pap smear tests are still abnormal, then you need to undergo colposcopy. If HPV is not detected or the following pap smear tests are normal, you will be advised to undergo a repeat examination three years later. Medium to severe changes. If the changes that occur in cells are significant enough, the doctor will give advice to undergo a colposcopy examination. This procedure aims to confirm the presence of cells at risk of becoming cancerous or called cervical intra-epithelial neoplasia (CIN). Further treatment must be done if the test results find cancer cells in the cervix. You can read more about treatment on the cervical cancer treatment page.

Colposcopy examination

Colposcopy is an examination using a colposcope, which is a kind of microscope, to see the whole cervix in more detail. This examination will be recommended if the results of a pap smear show the presence of abnormal cervical cells or if the HPV examination proves to be positive. Colposcopy is generally done by a specialist within 15-20 minutes. To undergo this process, you will be asked to lie down with your legs spread wide. Then, the doctor will insert an instrument called a speculum to see the vaginal wall and cervix. It is likely that the doctor will use vinegar (acetic acid) or iodine (Lugol's solution) beforehand, so that abnormal cells can be seen more clearly. If found, the doctor will take a sample of the tissue. This process of taking is called a biopsy. This tissue sample will then be analyzed with a microscope. Colposcopy will generally produce the following results:

• CIN is not found in cervical tissue after iodine or vinegar solution is applied.
• Vinegar or iodine indicate abnormal cells but not CIN. Precisely what happens is due to infection or other disorders besides cervical cancer
• After biopsy, the sample does not show any abnormal cells.
• The biopsy results showed the presence of abnormal cells that could potentially become cervical cancer.

If the biopsy results find abnormal cells that have the potential to be cancerous or CIN, then further treatment needs to be done.

Handling of Abnormal Cells

The results of the examination can be categorized based on the surface thickness of the cervix which changes cells, namely:

• Large loop excision of the transformation zone (LLETZ): the procedure of removing tissue containing abnormal cells using a spiral wire with a low voltage.
• Cone biopsy: the procedure of removing a portion of cervical tissue in the form of a cone with a scalpel.
• Trichectectomy or hysterectomy. Trachectomy is the removal of the cervix or cervix, but the uterus remains in place. While hysterectomy is the surgical removal of the cervix and uterus completely.

Other methods for dealing with abnormal cells are carried out in the following ways:

• Laser therapy. Direct the laser beam directly to destroy the abnormal area of ​​the cervix.
• Coagulation / Clumping. Using heat therapy to destroy abnormal cells.
• Cryotherapy. Abnormal cells are destroyed by freezing. However, this procedure is the most rarely performed because of its lowest effectiveness.

All of the above processes are carried out under the influence of local or general anesthesia. Generally this treatment successfully prevents the emergence of service cancer. But in some cases, it is still possible for abnormal cells to reappear. You are advised to undergo a re-examination. If abnormalities are detected again, you need to go back to colposcopy and further treatment if necessary.