Gynecologic Cancer Screening

Gynecologic cancer refers to any cancer that begins in a woman’s reproductive organs.

The uterus is at the center of the reproductive system, where a fertilized egg implants and grows during pregnancy. The ovaries are attached to the uterus’s top, producing eggs and hormones like estrogen. The cervix is the lower part of the uterus that opens into the vagina, a canal that connects the uterus to the outside of the body. The outer part of the female genitals is called the vulva.

Gynecologic cancer can begin in any of these organs or tissues when abnormal cells grow uncontrollably. Each type behaves differently and is classified based on where it originates:

• Cervical cancer. It is often linked to infection with the human papillomavirus (HPV), a common sexually transmitted infection. Regular screening has made cervical cancer one of the more preventable and treatable cancers when detected early.
• Endometrial or uterine cancer. It is the most common gynecologic cancer in the United States, with a higher occurrence in postmenopausal women. Unusual vaginal bleeding is often an early sign.
• Ovarian cancer. This cancer is often more challenging to detect because symptoms like bloating and abdominal pain can be vague. It’s more commonly diagnosed at a later stage.
• Vaginal cancer. Vaginal cancer is rare and may present with abnormal bleeding or a lump in the vaginal area.
• Vulvar cancer. This type affects the outer part of the female genitalia, causing symptoms such as itching or changes in the color or texture of the skin on the vulva.

Types of Gynecologic Cancer Screenings

When gynecological cancers are caught early, before they have spread, treatments like surgery or other therapies can often remove or destroy the cancer more easily. It also increases the chances of a full recovery and can reduce the need for more aggressive treatments later.
The primary types of screening tests used to detect gynecological cancers are:

1. Pap smear (Pap test)
   This is a routine test for detecting cervical cancer. Your doctor will gently scrape or brush a small sample of cells from the surface of your cervix. The cell sample is then sent to a lab to be examined under a microscope. If the test finds abnormal cells, it doesn’t always mean you have cancer, but it can be a sign that further testing is needed. The Pap test is important because it helps catch changes early, when they can be treated before they turn into cancer.
   For most women, a Pap smear is performed every 3 years until age 65. Some women may need more frequent testing if they have risk factors like a history of cervical cancer or are HIV positive.
2. HPV test
   The HPV test is used to detect the presence of human papillomavirus that can cause cervical and other cancers. During the test, your doctor will take a sample of cells from your cervix. The sample is sent to a lab, where they check for the DNA or RNA of high-risk HPV types. If the test detects these types of HPV, it means you may have a higher risk of developing cervical cancer, and your doctor will discuss the next steps, like additional testing or monitoring.
   This test can be performed at the same time as a Pap smear (HPV/Pap cotest) and is usually done every 5 years for women ages 30-65.
3. Pelvic exam
   During an annual pelvic exam, your doctor will check your reproductive organs, including the vagina, cervix, uterus, ovaries, vulva, and rectum, for any abnormalities. While this exam isn’t a cancer screening test itself, it helps detect potential issues that may require further testing.
4. Endometrial tissue sample
   For women at a higher risk for uterine cancer or those experiencing symptoms like abnormal bleeding, an endometrial biopsy can be performed. This involves taking a small tissue sample from the uterus to check for cancerous cells.
   There are no standard screening tests for ovarian, uterine, vaginal, or vulvar cancers. However, regular gynecologic exams and being aware of any changes in your body can help catch these cancers early.

Gynecologic Cancer Risks

Certain factors can increase your risk of developing gynecologic cancer.

• Cervical, vaginal, and vulvar cancers are often linked to HPV, a sexually transmitted infection. Safe sex practices and the HPV vaccine can lower your risk.
• As women age, the risk of uterine and ovarian cancers increases.
• Family history can influence the risk of certain gynecologic cancers, especially ovarian.
• Mutations in genes like BRCA1 and BRCA2 increase the risk of ovarian cancer. Genetic testing can help identify those at higher risk.

Gynecologic Cancers Symptoms

Symptoms vary depending on the type. Many are vague or similar to other benign conditions, so it’s essential to see your doctor if anything feels unusual, or you are experiencing:

• Abnormal vaginal bleeding or discharge
• Pelvic pain or bloating
• Frequent urination or constipation
• Itching or visible lesions

Remember, you don’t have to wait for symptoms to appear before taking action.

Routine screenings like Pap smears and pelvic exams are simple steps you can take to safeguard your health.

Gynecologic Cancer FAQs

1. What is the role of genetic testing in preventing gynecologic cancers?

Genetic testing can help identify whether you carry mutations in genes like BRCA1 and BRCA2, which increase the risk of ovarian and breast cancers. If you have a family history of these cancers, genetic counseling and testing can help guide preventive measures, such as more frequent screenings or risk-reducing strategies.

2. Are there vaccines that can help prevent gynecologic cancers?

Yes, the HPV vaccine is available and recommended for girls and women between the ages of 11 and 26. This vaccine protects against the types of HPV that most commonly cause cervical, vaginal, and vulvar cancers.