Ms. Lee, 52, was recommended for cervical cancer screening three years ago during a routine health check-up. Although she did not have any symptoms of discomfort, the test results showed signs of precancerous changes in the cervix. Thanks to this discovery, Ms. Li received timely medical intervention and avoided further development of the cancer. Her case highlights the importance of cervical cancer screening, especially for middle-aged and older women, which is undoubtedly a potential life-saving measure.
This true story reminds us that cervical cancer can be effectively prevented and treated through early screening. According to the World Health Organization, cervical cancer is the fourth most common type of cancer among women worldwide, with about half a million newly diagnosed cases each year, most of which occur in low- and middle-income countries. However, in developed countries, the incidence and mortality of cervical cancer have dropped dramatically due to extensive screening programs.
Standard recommendations for cervical cancer screening: Who needs to be screened and how often?
Who should be screened for cervical cancer?
Cervical cancer screening is mainly for sexually active women. Medical guidelines may vary slightly from country to country, but it is generally recommended to start a Pap smear at age 21 or within three years of the start of sexual activity. For women aged 30 years and older, it is recommended to add testing for human papillomavirus (HPV), as HPV is the leading cause of cervical cancer.
How often are screenings performed?
Women between the ages of 21 and 29: A Pap smear is recommended every three years. HPV testing is not recommended at this age unless the Pap smear result is abnormal.
Women between the ages of 30 and 65: A Pap smear combined with an HPV test is recommended every five years, or a Pap smear test only every three years.
Women over 65 years of age: Continued screening is usually not necessary if previous screening results are consistently normal and there are no risk factors for cervical cancer (such as suppressed immune system or previous high-grade lesions).
Choose the right screening method
Pap smear: This is a quick and relatively simple test that examines abnormal cells by taking a small sample of cervical cells.
HPV test: This test detects the DNA of high-risk HPV types in a sample of cervical cells. Because some types of HPV are strongly associated with cervical cancer.
These screening guidelines are based on a large body of research and data and aim to maximize the effectiveness of cervical cancer prevention while reducing unnecessary medical interventions. While following these guidelines, women should discuss their individual's risk factors, such as family medical history and past medical records, with their doctor to tailor a screening plan that works best for them.
Over-checking: a double-edged sword in medical screening
Understand what excessive medical screening really looks like
Over-examination, which refers to a medical examination that is performed without clinical necessity. This phenomenon can lead to unnecessary medical interventions, increasing the financial burden and psychological stress of patients. Cervical cancer screening, especially Pap smear and human papillomavirus (HPV) testing, is likely to lead to over-testing if not performed at the medically recommended frequency and for the target.
The risk of over-inspection cannot be ignored. First of all, frequent unnecessary tests may cause unnecessary psychological burden and fear in patients. Second, these tests can lead to misdiagnosis and overtreatment, such as unnecessary biological tests and surgeries, which can be physically harmful. For example, invasive tests such as cervical biopsies, if not reasonably clinically indicated, can lead to infection, bleeding, or other complications.
Strategy: Avoid over-screening and perform cervical cancer screening appropriately
1. Strengthen doctor-patient communication
Open, transparent communication between physicians and patients is essential. Doctors should explain to patients the necessity of testing, the possible risks, and the expected outcomes so that patients can make informed decisions. In addition, doctors should encourage patients to ask questions and express their concerns, which can help patients understand their health and medical needs and avoid unnecessary tests.
2. Adopt individualized medical decision-making
Each patient's health and medical needs are unique. Therefore, a cervical cancer screening program should be tailored based on the patient's age, health status, family medical history, and previous medical records. Physicians should use existing medical guidelines as a basis to adjust the frequency and method of screening to suit each patient's specific situation.
3. Educate patients on informed choice
Patient education is key to preventing over-testing. Healthcare facilities should provide educational materials and workshops to help patients understand the importance of cervical cancer screening and the standard procedures implemented. By providing clear information and recommendations, patients can better understand when what tests are necessary and when they may be excessive.
4. Emphasize the importance of medical evidence
Before undergoing any medical examination or treatment, both doctors and patients should make decisions based on the latest medical evidence. Physicians should refer to the latest research and clinical trial results to recommend or discourage certain medical tests to ensure that every step of the medical treatment is supported by adequate science.