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Ракът на маточната шийка се развива, когато анормални клетки на шийката на матката нарастват безконтролно. Шийката на матката е най-долната част на матката, която се отваря към вагината. Този вид тумори могат да бъдат лекувани успешно, когато се установят по-рано. Цитонамазката или колпоскопията са изследванията, които всяка жена трябва да прави веднъж на 2-3 г. Ракът на маточната шийка е едно от най-често срещаните онкологични заболявания при жените в цял свят. У нас годишно умират около 360 жени с тази диагноза. В страни като САЩ и други, където скринингът за рак на шийката на матката е рутинен, има по-малко тумори. Повечето случаи на това злокачествено заболяване се причиняват от човешкия папиломен вирус (HPV). Предава се по полов път. Има много типове на HPV вируса. Не всички водят до рак на маточната шийка. Някои от тях са причина за генитални брадавици, други видове пък може да не предизвикват никакви симптоми. Повечето хора в някакъв момент са били инфектирани с HPV (на снимката вдясно). В началото инфекцията няма осезаеми симптоми. Често организмът се самоочиства. В други случаи – когато имунната система по една или друга причина не успява да се справи с вирусите, се стига до злокачествен процес. Ето защо е важно жените да ходят редовно на цитонамазка. При нея се взема проба клетки от маточната шийка, които се изследват под микроскоп. Т.нар. Пап тест открива дори начални промени в цервикалните клетки, преди те да са се превърнали в рак. Ако се отнасяте към тези клетъчни изменения, може да предотврати рак на маточната шийка.
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Pap smear is a screening test to detect abnormalities in the cells of the uterine cervix. The abnormality is called dysplasia. There is a possibility that the dysplasia may lead to cervical cancer. If dysplasia develops then the follow up may be done at the office. Cervix of the uterus The cervix is the lower part of the uterus that is connected with the vagina. It is covered by a thin layer of cells similar the one that cover the mouth. These cells replicate constantly. The cells migrate from the basal to the top layer and they exfoliate. During this process, the cells may become dysplastic. Pap Smear Pap smear is a very important exam for the health of the woman. During this test, cells from the cervix are collected and they are examined under the microscope. This test tells us if there are dysplastic or precancerous cells in the cervix. Precancerous cells are the ones that may become cancerous. Dysplasia is usually caused by human papillomaviruses (HPV). Dysplasia is not cancer but it is precancerous condition that may become cancer. Infection with Human Papillomavirus Infection with HPV may show dysplasia during a Pap smear. However, most women with HPV infection do not have dysplasia. It is a quite common infection that can be transmitted to sexual partners. Some HPV types are related to cervical cancer, vaginal cancer, anal and vulvar cancer. Follow up of an abnormal Pap smear The abnormal Pap smear results need to be evaluated further. The evaluation is done by colposcopy and possibly by cervical biopsy. The body can often fight the dysplasia. The best way to treat the dysplasia is to detect it early. Colposcopy During colposcopy, the physician observes the cervix under magnification with an instrument called colposcope. The physician can detect lesions of the cervix that are not visible with naked eye. During colposcopy, a speculum is placed in the vagina, like the Pap smear exam. A solution, similar to the vinegar, called acetic acid is placed on the cervix. This may cause tingling sensation. It makes the lesions more distinct. The colposcope remains outside the vagina and used only for observation. Cervical biopsy During colposcopy, the physician may take cervical biopsy from a dysplasia site. There is no need for anesthesia during biopsy but you can feel a pinch. The biopsy results are going to assist whether you need further treatment. Treatment The treatment of cervical dysplasia depends on their grade (severity). You may need only follow up with a Pap smear earlier or a minor surgical procedure. The surgical procedure may include removal of a thin layer of the cervix or rarely hysterectomy. If there is a need for removal of a thin layer of the cervix which is called cone biopsy, this can be done either with knife or with Loop Ectrosurgical Excision Procedure (LEEP), which is a special instrument which uses current. These are considered minor surgeries and are done as an outpatient procedure. If you are concerned for abnormal Pap smear results, discuss it with your physician. You should keep in mind that if dysplasia is detected early then there is successful treatment. Pap smear is the best test for early detection of abnormalities in the cervix. George Papanikolaou has saved million of lifes with the discovery of the pap smear and the early detection of precancerous lesions of the cervix of the uterus.