Cancer Screening / Annual Gynecological…

ANNUAL GYNECOLOGICAL EXAMINATION

In order to maintain good reproductive and sexual health, females should visit a gynecologist – a doctor who specializes in females’ reproductive health – for an exam about once per year. Generally, females should begin seeing a gynecologist at the age of 21, but begin earlier if they become sexually active. After their first visit, females ages 21 to 29 should visit their gynecologist annually to get a Pap smear. Females between the ages of 30 to 64 should generally visit every other year.

A gynecological exam can include discussions about personal and family medical history, sexual history, safe sex an alternative contraceptive options. Appointments are also a great time for you to address any questions you may have, including questions about irregular periods, vaginal discharge, STIs, and pregnancy tests.

Pelvic Exam: A pelvic exam is a way for doctors to look for signs of illness in certain organs in a woman’s body. The word “pelvic” refers to the pelvis. The exam is used to look at a woman’s: Vulva (external genital organs), Uterus (the womb), Cervix (opening from the vagina to the uterus), Fallopian tubes (tubes that carry eggs to the womb), Ovaries (organs that produce eggs), Bladder (the sac that holds urine), Rectum (the chamber that connects the colon to the anus).

During the pelvic exam, the doctor will examine the vulva (exterior genitalia) to check for signs of irritation, infection, or sores. The doctor will insert a lubricated speculum into the vagina. The closed speculum is inserted into the vagina and then slowly opened to separate the vaginal walls. This provides the gynecologist with a view of the vaginal wall and cervix. If your muscles are relaxed, the speculum should only cause a slight amount of pressure. Slight discomfort is common, but be sure to let your gynecologist know if you are experiencing considerable pain.

The physician will swipe the cervical mucus with a cotton swab to collect a sample of cervical cells. This procedure is called a Pap smear. Pap smears are used to detect the presence of abnormalities that can be caused by cervical cancer, vaginal infections, or STIs.

The doctor will manually examine the reproductive organs. Wearing latex gloves, the doctor will insert one or two lubricated fingers into the vagina, and press on the lower abdomen with the other hand, in order to physically feel the female’s internal reproductive organs. This procedure checks the size, shape, and position of the uterus, which can affect fertility and the type of contraception that should be used. It also checks for swelling or tenderness in the vagina and reproductive organs. These may be signs of an infection, pregnancy, or cysts.  As with the other components of the pelvic exam, this procedure should be quick and cause only mild pressure or discomfort. If you experience pain at any point in the exam, be sure to let your doctor know. Your gynecologist may also insert a gloved finger into the rectum to check for abnormalities behind the uterus, vaginal wall, or rectum.

After the gynecologist has completed the physical examination, there will be a final opportunity to discuss with your doctor any other additional questions or concerns you may have.

Pelvic ultrasound is an examination used to assess organs and structures of the female pelvis. It allows visualization of the female reproductive system including uterus, cervix, fallopian tubes and ovaries. This provides as information about size, location and structure of pelvic masses but cannot provide definite diagnosis of cancer or specific disease. A pelvic ultrasound may be use to diagnose and assist in the treatment of uterine fibroids, abnormalities in the anatomic structure of the uterus, presence and position on intrauterine device (IUD), ovarian cysts / follicular tracking for infertility evaluation. Pelvic ultrasound can be done either transabdominal or transvaginal ultrasound. Your healthcare provider will advise you what approach will the ultrasound be performed.

CERVICAL CANCER SCREENING

Cervical Cancer occurs when abnormal cells on the cervix grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer is one of the most common cancers in women worldwide.

Most cases of cervical cancer are caused by infection with HPV. HPV is a virus that enters cells and can cause them to change. Some types of HPV have been linked to cervical cancer as well as cancer of the vulva, vagina, penis, anus, mouth, and throat. Types of HPV that may cause cancer are known as “high-risk types.”

HPV is passed from person to person during sexual activity. It is very common, and most people who are sexually active will get an HPV infection in their lifetime. HPV infection often causes no symptoms. Most HPV infections go away on their own. These short-term infections typically cause only mild (“low-grade”) changes in cervical cells. The cells go back to normal as the HPV infection clears. But in some women, HPV does not go away. If a high-risk type of HPV infection lasts for a long time, it can cause more severe (“high-grade”) changes in cervical cells. High-grade changes are more likely to lead to cancer.

Cervical cancer can often be successfully treated when it’s found early. It is usually found at a very early stage through a Pap test.

Cervical cancer screening is used to find changes in the cells of the cervix that could lead to cancer. Screening includes cervical cytology (also called the Pap test or Pap smear) and, for some women, testing for human papillomavirus (HPV). Both tests use cells taken from the cervix. The screening process is simple and fast. You lie on an exam table and a speculum is used to open the vagina. The speculum gives a clear view of the cervix and upper vagina.

Cells are removed from the cervix with a brush or other sampling instrument.

The cells usually are put into a special liquid and sent to a laboratory for testing:

For a Pap test, the sample is examined to see if abnormal cells are present.

For an HPV test, the sample is tested for the presence of 13 – 14 of the most common high-risk HPV types.

Women aged 21–29 years should have a Pap test alone every 3 years. HPV testing is not recommended. Women aged 30–65 years should have a Pap test and an HPV test (co-testing) every 5 years (preferred). It also is acceptable to have a Pap test alone every 3 years.

Screening Tests for Breast Problems:

screening test is used to find diseases, such as cancer, in people who do not have signs or symptoms. This allows early treatment. The earlier cancer is treated, the greater the chance of survival.

Screening for breast problems includes:

     –     Mammography: is an X-ray technique used to study the breasts. No dyes have to be injected or swallowed, and no instruments will be put in your body. Mammography is done as a screening test to regularly check for breast cancer in women who do not have signs or symptoms of the disease, and as a diagnostic test to check lumps or other symptoms that you have found yourself or that have been found by a healthcare provider.

     –     Clinical Breast Exam: an examination of your breasts during routine checkups. Women aged 29–39 years should have a clinical breast exam every 1–3 years. Women aged 40 years and older should have one every year. The exam may be done while you are lying down, sitting up, or both. You may be asked to raise your arms over your head. The breasts are first checked for any changes in size or shape. Your healthcare provider also looks for puckers, dimples, or redness of the skin. He or she then feels for changes in each breast and under each arm. The nipple may be gently squeezed to check for discharge.

 –     Breast Awareness: In the traditional breast self-exam, you use a precise method to examine your breasts on a regular basis, such as once a month. Breast self-awareness does not require you to examine your breasts once a month or with a precise method. Instead, it focuses on having a sense of what is normal for your breasts so that you can tell if there are changes – even small changes – and report them to your healthcare provider.

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