Preventive Oncology

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This speciality deals with screening of women for detecting precancer lesions in the body which might, if left untreated, turn into cancer after several years. It is most commonly done for cancer of the cervix (mouth of the womb). In most Western countries, this is done in an organized manner where all or most women undergo a PAP test once every 3-5 years starting approximately from the age of 21 years. In India, this is often done when women voluntarily ask for the test or when the doctor offers it as part of a general health check. It is recommended that all women undergo a Pap test, since it helps in early detection of abnormal cells , which may then be treated appropriately. This helps to prevent development of cancer.

Pap test is a simple and safe test which can be done at the time of a vaginal examination. It does not require anesthesia, is usually painless and takes less than a minute. The woman is asked to lie down on the examination couch and a speculum is inserted gently into the vagina to get a clear view of the cervix. A spatula and sometimes a brush is used to remove some cells from the cervix by gently brushing over it. These cells are spread over a glass slide and sometimes collected in a jar of liquid and sent to the lab. The cells are then seen under the microscope to detect any abnormal changes.

If the PAP test shows an abnormal result it does not mean that the women has cancer. It just means that abnormal cells are found. These cells may in many cases disappear after some time without any treatment. Depending on the type of abnormal cells, a colposcopy or a repeat PAP test after six months may be advised.

Colposcopy is viewing of the cervix, vagina or vulva under magnification using an instrument called the colposcope. This procedure is also done without anesthesia and helps the doctor to have a detailed look at the cervix, so that more information can be obtained if an abnormality is suspected. If so, a biopsy may be taken from the abnormal site and sent to the lab for testing. Based on this report, further treatment can be planned.