Comprehensive Guide To Cervical Cancer Screening: Importance, Methods And Benefits
Discover how regular screening, HPV (Human Papillomavirus) vaccination and awareness can help prevent cervical cancer and ensure early, effective treatment.
Written by Dr Sonia Bhatt
Last updated on 3rd Jul, 2025
Cervical cancer develops from cells lining the cervix- the lower part of the uterus that extends to the vagina. This cancer begins when cells in the cervix get mutated over time, growing malignantly and forming abnormal tissues. The early detection of these cellular alterations through screening may help reduce mortality rates.
This article examines the key aspects of cervical cancer screening, including the types of tests, the interpretation of results, and potential challenges during the screening process. It aims to equip healthcare providers and patients with the essential knowledge to make informed decisions about preventive care.
Understanding Cervical Cancer
Cervical cancer is mainly attributable to long-standing infection with high-risk HPV (Human Papillomavirus). Among these, HPV-16 and HPV-18 are responsible for 70% of cases worldwide. Key risk factors include:
The chances of having high-risk HPV infection rise where one has early sexual activity (before 18 years) or has many partners.
A reduced ability to suppress HPV infections is often observed in individuals with AIDS (Acquired Immunodeficiency Syndrome), autoimmune diseases, or those taking immunosuppressive drugs.
Tobacco chemicals harm cervical cells and increase the risk of cervical cancer by twice if one is a smoker or exposed to secondhand smoking.
Some HPV infections are transient, and about 70% are cleared from the body within 1-2 years without ill effects. However, long-term, high-risk HPV infections may cause cervical cells to become abnormal and develop precancerous lesions. In the absence of treatment, the lesions, as mentioned earlier, may result in cervical cancer.
Methods of Cervical Cancer Screening
Early detection is crucial in cervical cancer, making screening methods invaluable. Two primary techniques are commonly used: the Pap smear test and the HPV DNA (Deoxyribonucleic Acid) test.
A Pap smear involves scraping cervical cells during physical examination and examining the specimen under a microscope. It can diagnose pre-cancerous or even cancerous conditions and tissue alterations not linked to cancer, such as inflammation.
HPV DNA Test examines the presence of the high-risk HPV types that cause cervical cancer, even if the Pap smear is negative. It gives an initial clue of any infection that might progress to cause cancer.
Integrating a Pap smear and HPV DNA test is more effective in early diagnosis and is recommended for women over 30.
Importance of Regular Screening
Cervical cancer screening should be done often to increase the chances of identifying the condition. It detects precancerous lesions, which can lead to invasive cervical cancer. Health organisations, including the American Cancer Society (ACS), recommend:
Cervical cancer screening should begin at the age of 25 every 5 years.
It is appropriate to have an HPV/Pap co-test every 5 years or a Pap test every 3 years.
Screening can be stopped at 65 for women who had regular annual examinations in previous years.
Regular screening significantly lowers the incidence and mortality of cervical cancer, with the following reductions noted:
A 67% decrease in early-stage (1A) cervical cancer cases.
A 95% decrease in cases of stage 3 or more advanced forms of the disease.
Interpreting Cervical Cancer Screening Results
Screening results allow healthcare professionals to evaluate the probability of cervical cancer and the subsequent actions to be taken. Below are the common screening results:
Negative HPV Test: High-risk HPV was not detected, indicating no current issues. Patients are advised to return for screening in five years.
Positive HPV Test Without Cell Changes: The test is positive for high-risk HPV, but there are no signs of cervical abnormalities. A follow-up exam is recommended within a shorter interval.
Positive HPV Test with Cell Changes: Cell alterations are usually low-grade or high-grade, indicating probable precancerous lesions.
Unsatisfactory Result: The sample collected was inadequate, requiring the test to be retaken for an accurate assessment.
Consult Top Gynaecological Oncologists With HPV Test Result
For abnormal results, the doctor may recommend:
Colposcopy: It is a biopsy that involves the use of a special optical instrument to make observations of cervical areas that look suspicious.
Biopsy: Taking a biopsy of cervical tissues can be recommended for further benchmarking.
Treatment: If needed, specific procedures, such as Loop Electrosurgical Excision Procedure (LEEP), may be done to remove the abnormal tissue that may lead to cancer.
Advances in Screening Techniques
New technologies are improving cervical cancer screening by increasing the precision, speed, and reach, especially in developing nations.
HPV DNA Testing: Regarded as the gold standard, it identifies high-risk HPV types with higher sensitivity than cytology-based Pap smears.
Automated Visual Evaluation: AI analyses cervical images to detect precancerous changes, offering faster and more accurate results, especially in regions with limited medical resources.
Liquid-Based Cytology: It is an advanced method of performing the Pap smear using liquid samples, providing enhanced capability to analyse cells and detect abnormalities.
Epigenetic Markers: The studies on DNA methylation patterns as biomarkers predict the possibility of identifying more accurate early-stage precancerous lesions.
Future screening methods are moving towards personalised approaches, including:
HPV E6/E7 Oncoprotein Testing: This method enhances specificity to reduce false positives and decreases sensitivity to minimise false negatives by focusing on viral proteins.
Less Frequent Screening: Advanced tests can extend the time between necessary screenings for vaccinated individuals.
Global Accessibility: Efforts to provide affordable, sustainable technologies for widespread HPV vaccination and cervical cancer screening support the WHO’s (World Health Organisation) goal of eliminating cervical cancer.
Challenges in Cervical Cancer Screening
Despite high achievements in cervical cancer prevention, several obstacles prevent adequate screening and result in the high prevalence of cervical cancer.
Primary care and speciality services are scarce in rural and poor-population zones, and few skilled personnel are available for screening.
Expenses are enormous and may discourage women, especially those from poor backgrounds.
Lack of adequate healthcare facilities and then problems with logistics influence the quality and accessibility of screening.
Awareness and Education
Cervical cancer and its associated risk factors, along with the benefits and procedures of screening, remain unfamiliar to many women due to hesitancy and lack of awareness.
The stigma surrounding discussions of female private parts is also driven by cultural beliefs and prejudices that marginalise and condemn women's health.
Promoting the utility of screenings and advertising HPV vaccination can increase participation.
Some recommendations include persuading women to get tested as soon as they reach the recommended age of 25.
Role of Vaccination in Prevention
HPV vaccine is an essential weapon in cervical cancer prevention because it focuses on high-risk subtypes that cause most of the cancers. HPV vaccine guards against cervical cancer and other cancers causing HPV types.
The Centers for Disease Control and Prevention (CDC) encourages children to be vaccinated at ages 11-12, with vaccination starting at age 9.
For individuals who are unable to receive earlier doses, vaccination is also recommended for those up to the age of 26.
Epidemiological research demonstrates that the vaccine lowers cervical cancer risk by 63% among women who took the shots, thus reducing the risk of precancerous lesions.
Conclusion
Cervical cancer is mainly a preventable type of cancer if women undergo regular Pap smears and if they are vaccinated against HPV. Education and support for women are key to making the elimination of cervical cancer a reality. It is crucial to be aware of the different screening methods and when to opt for proactive medical intervention.
Consult Top Gynaecological Oncologists With HPV Test Result
Dr. Navin Srinivasan
Obstetrician and Gynaecologist
9 Years • MBBS, MS, DNB (OBS-GYNAE), MCH (GYNE ONCOLOGY) MRCOG - 2 (Gold Medalist )
Bengaluru
Apollo Clinic, Sarjapur Road, Bengaluru
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Kolkata
Dr Utsa Basu Clinic, Kolkata
Dr. Sushith C
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Amit Choraria
Surgical Oncologist
18 Years • MBBS, MS (Surgery) Fellow, Surgical Oncology, Tata Medical Center (FSO) Fellow, European Board of Surgery (Surgical Oncology) (FEBS) Fellow, Minimal Access Surgery (FMAS) Fellow, Indian Association of Gastrointestinal Endosurgeons (FIAGES) UICC Fellow, Royal Marsden NHS, London, UK Visiting Scholar, Plastic Reconstructive Surgery, CGMH, Taiwan Fellow, Robotic Surgical Oncology, Vattikuti Foundation, USA
Kolkata
Apollo Multispeciality Hospitals , Kolkata, Kolkata
(50+ Patients)
