Cervical screening Health Dictionary

Cervical Screening: From 1 Different Sources


*screening tests to detect the presence of precancerous changes in the cervix (neck) of the uterus (see cervical intraepithelial neoplasia). *Cervical smears are the standard first-line screening tools in most countries: screening programmes based on the traditional Papanicolaou (Pap) test have been mostly superseded by *liquid-based cytology. *Colposcopy is indicated when abnormal cells (*dyskaryosis) are detected.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Cervical

Cervical means anything pertaining to the neck, or to the neck of the womb.... cervical

Cervical Cancer

Cancer of the cervix – the neck of the womb – is one of the most common cancers affecting women throughout the world. In some areas its incidence is increasing. This cancer has clearly identi?able precancerous stages with abnormal changes occurring in the cells on the surface of the cervix: these changes can be detected by a CERVICAL SMEAR test. Early cancer can be cured by diathermy, laser treatment, electrocoagulation or cryosurgery. If the disease has spread into the body of the cervix or beyond, more extensive surgery and possibly radiotherapy may be needed. The cure rate is 95 per cent if treated in the early stages but may fall as low as 10 per cent in some severe cases. Around 3,000 patients are diagnosed as having cervical cancer every year in the United Kingdom, and around 1,500 die from it. Latest ?gures in England show that the incidence rates have fallen to under 11 per 100,000 women, while death rates fell by more than 40 per cent during the 1990s. The sexual behaviour of a woman and her male partners in?uences the chances of getting this cancer; the earlier a woman has sexual intercourse, and the more partners she has, the greater is the risk of developing the disease.... cervical cancer

Cervical Smear

This screening test detects abnormal changes in the cells of the cervix (see CERVIX UTERI), enabling an affected woman to have early treatment. The National Health Service has arrangements to check women regularly. A woman’s ?rst test should be within six months of her ?rst experience of intercourse and thereafter at three-yearly intervals for the rest of her life. The test is simple, with some cells being scraped o? the cervix with a spatula and the tissue then being examined microscopically.... cervical smear

Cervical Vertebrae

The seven bones of the top end of the backbone that form the neck. The ?rst cervical vertebra is the atlas and this articulates with the base of the skull. The axis is the second vertebra, which contains a shaft of bone that allows the atlas to rotate on it, thus permitting the head to turn. (See SPINAL COLUMN.)... cervical vertebrae

Genetic Screening

A screening procedure that tests whether a person has a genetic make-up that is linked with a particular disease. If so, the person may either develop the disease or pass it on to his or her o?spring. When an individual has been found to carry a genetically linked disease, he or she should receive genetic counselling from an expert in inherited diseases.

Genetic screening is proving to be a controversial subject. Arguments are developing over whether the results of such screenings should be made available to employers and insurance companies – a move that could have adverse consequences for some individuals with potentially harmful genetic make-ups. (See GENES; GENETIC DISORDERS.)... genetic screening

Screening

The use of procedures and measures to identify and differentiate apparently well persons who have a disease or condition or a high risk thereof from those who probably do not have the disease or condition.... screening

Screening Test

The screening of apparently healthy people to identify those who may have treatable diseases. Cervical smears are done when screening women to detect if they have cancer or precancer of the neck of the womb (cervix). Newborn babies are screened for hip dislocation. Screening tests are not designed to diagnose individual persons, but rather to divide a population into a large number at low risk and a small number at high risk of a condition. This allows clinicians to concentrate on a sub-section of the population. All screening tests produce false negative and false positive results, a problem often misunderstood by those at the receiving end. Factors to be assessed when planning screening procedures include the severity, frequency and distribution of the disease, and the availability and e?ectiveness of treatment. Convenience, safety, sensitivity and cost should also be assessed. In the United Kingdom the government has supported the extension of screening procedures for breast cancer, cervical cancer, hypertension and diabetes. (See PREVENTIVE MEDICINE.)... screening test

Cervical Incompetence

Abnormal weakness of the cervix that can result in recurrent miscarriages. An incompetent cervix may gradually widen under the weight of the fetus from about the 12th week of pregnancy onwards, or may suddenly open during the second trimester. The condition is detected by an internal examination or by ultrasound scanning.

Treatment is with a suture (stitch) applied like a purse string around the cervix during the 4th month of pregnancy. The suture is left in position until the pregnancy is at or near full term and is then cut to allow the mother to deliver the baby normally.... cervical incompetence

Cervical Intraepithelial Neoplasia

Also known as , abnormalities in the cells of the cervix which may become cancerous.

The grading system is used to distinguish levels of change in the surface cells of the cervix in biopsy samples taken during colposcopy, a procedure usually performed following an abnormal cervical smear test.

Grades 1–3 broadly correspond to mild to severe cervical dysplasia in cells obtained from a smear.... cervical intraepithelial neoplasia

Breast Screening

A set of investigations aimed at the early detection of breast cancer. It includes self-screening by monthly examination of the breasts, and formal programmes of screening by palpation and mammography in special clinics. In the UK the NHS o?ers regular mammography examinations to all women between 50 and 64 years of age; in 1995–6, 1.1 million women were screened – 76 per cent of those invited. More than 5,500 cancers were detected – 5.3 per 1,000 women screened.... breast screening

Cervical Venosities

Enlarged varicose veins on the cervix of the uterus, often accompanying ulcerations or long-term pelvic congestion. A symptom only of congestion or impaired circulation, they can occur in both semi-trivial and serious conditions.... cervical venosities

Prenatal Screening Or Diagnosis

Prenatal screening of fetal abnormalities may be the result of screening tests carried out on most or all pregnant women, or as the result of speci?c diagnostic tests performed to detect speci?c conditions. Prenatal diagnosis is important as it will identify babies who might need medical or surgical treatment before or soon after birth. In addition, it may also detect severe abnormalities for which parents might decide to have a therapeutic ABORTION.

ULTRASOUND scanning is probably the most widely used diagnostic tool in obstetric practice. It can detect structural abnormalities such as SPINA BIFIDA and CLEFT PALATE and even cardiac and renal problems. A series of scans can assess whether the baby is growing at a normal rate; ultrasound may also be used to assist with other diagnostic tests (e.g. AMNIOCENTESIS – see below).

Tests on the mother’s blood can also diagnose fetal abnormalities. Alphafetoprotein (AFP) is produced by babies and ‘leaks’ into the AMNIOTIC FLUID and is absorbed by the mother. In spina bi?da and other neural-tube defects there is increased leakage of AFP, and a blood test at 16 weeks’ gestation can detect a raised level which suggests the presence of these abnormalities.

The triple test, also performed at 16 weeks, measures AFP and two hormones – HUMAN CHORIONIC GONADOTROPHIN and unconjugated OESTRADIOL – and is used in diagnosing DOWN’S (DOWN) SYNDROME.

Amniocentesis involves inserting a needle through the mother’s abdominal wall into the uterus to remove a sample of amniotic ?uid at 16–18 weeks. Examination of the ?uid and the cells it contains is used in the diagnosis of Down’s syndrome and other inherited disorders. The test carries a small risk of miscarriage.

Chorionic villus sampling may be used to diagnose various inherited conditions. A small amount of tissue from the developing PLACENTA is removed for analysis: this test has the advantages of having a lower incidence of miscarriage than amniocentesis and is carried out at an earlier stage (9–13 weeks).

Analysis of a blood sample removed from the umbilical cord (cordocentesis) may diagnose infections in the uterus, blood disorders or inherited conditions.

Direct observation of the fetus via a viewing instrument called a fetoscope is also used diagnostically and will detect structural abnormalities.

Most tests have a recognised incidence of false positive and negative results and are therefore usually cross-checked with another test. Counselling of the parents about prenatal tests is important. This allows them to make an informed choice which may not necessarily involve terminating the pregnancy if an abnormality is found. (See PREGNANCY AND LABOUR.)... prenatal screening or diagnosis

Cancer – Cervical

See: CANCER OF THE WOMB. ... cancer – cervical

Cancer Screening

Tests to detect early signs of cancer in groups of people who are susceptible to cancer because of their age, occupation, lifestyle, or genetic predisposition. Tests for cancers of the cervix (see cervical smear test), breast (see mammography), bladder, and colon have proven to be effective.... cancer screening

Cap, Cervical

A flexible contraceptive device placed directly over the cervix to prevent sperm from entering (see contraception, barrier methods of).... cap, cervical

Cervical Erosion

A condition affecting the cervix in which a layer of mucusforming cells more characteristic of those found in the inner lining of the cervix appear on its outside surface. The eroded cervix has a fragile, reddened area on the surface. Usually, there are no symptoms, but some women experience bleeding at unexpected times and may have a vaginal discharge.

Cervical erosion may be present from birth. Other causes include injury to the cervix during labour and long-term use of oral contraceptives. The condition is often detected during a routine cervical smear test.

Only women who have symptoms need treatment.

Abnormal tissue may be destroyed using cauterization, cryosurgery, diathermy, or laser treatment.... cervical erosion

Cervical Mucus Method

A form of contraception based on identifying periods for abstinence from intercourse according to the changes in the mucus secreted by a woman’s cervix (see contraception, natural methods of).... cervical mucus method

Cervical Osteoarthritis

A degenerative disorder, also known as cervical spondylitis, that affects the joints between the cervical vertebrae (bones in the neck). Cervical osteoarthritis mainly affects middle-aged and elderly people, but occasionally the degeneration begins earlier due to an injury.

Symptoms of cervical osteoarthritis may include pain and stiffness in the neck, pain in the arms and shoulders, numbness and tingling in the hands, and a weak grip. Other symptoms such as dizziness, unsteadiness, and double vision when turning the head may also occur. Rarely, pressure on the spinal cord can cause weakness or paralysis in the legs and loss of bladder control.

Treatments include heat treatment and analgesics.

Physiotherapy may improve neck posture and movement.

Pressure on the spinal cord may be relieved by surgery (see decompression, spinal canal).... cervical osteoarthritis

Cervical Rib

A congenital abnormality in which the lowest of the 7 cervical vertebrae (neck bones) has overdeveloped to form an extra rib parallel to and above the 1st normal rib.

Symptoms may occur if the rib begins to press on the lower brachial plexus (the group of nerves passing from the spinal cord into the arm), causing pain, numbness, and pinsand-needles in the forearm and hand.

Exercises to strengthen the shoulder muscles and improve posture may bring relief.

Severe or persistent symptoms may require surgery to remove the rib.... cervical rib

Cervical Smear Test

A test to detect cervical dysplasia (abnormal changes in the cells of the cervix) that could develop into cervical cancer (see cervix, cancer of). A smear test also detects viral infections of the cervix, such as herpes simplex and papilloma (see warts, genital). The test should be carried out 6 months after a woman starts to have sexual intercourse, with a repeat test 6–12 months later, and then every 3 years.

A sample of cells is taken from the surface of the cervix using a spatula and examined under a microscope.

If cells appear normal, nothing further needs to be done.

If cells show dysplasia, further investigations may be required.... cervical smear test

Cervical Spondylosis

An alternative name for cervical osteoarthritis.... cervical spondylosis

Cervical Cerclage

a procedure to help prevent *preterm delivery. It involves inserting a purse-string suture around the cervix of the uterus between 12 and 14 weeks gestation, either transvaginally or transabdominally, to keep the cervix closed and reduce the possibility of preterm cervical dilatation and rupture of membranes.... cervical cerclage

Cervical Ectopy

see ectropion.... cervical ectopy

Cervical Fracture

a fracture of a vertebra in the neck (see cervical vertebrae). Cervical fractures range from minor, requiring no treatment, to those associated with paralysis and instant death. Treatment can be support with a collar, skull traction, an *orthosis attached to the skull, or surgery, depending on the severity of the fracture.... cervical fracture

Cervical Resistance Index

measurement of the resistance of the cervix during the passage of a series of metal (Hegar) dilators. Lack of resistance in a nonpregnant women may suggest cervical weakness when she has experienced a previous second-trimester pregnancy loss or if she has had previous surgery to the cervix, and may indicate *cervical cerclage in the event of future pregnancies.... cervical resistance index

Crafft Screening Test

a screening tool for young people under the age of 21 to identify alcohol and drug use. The first part consists of three questions about drug or alcohol use over the past year. Participants giving positive answers to two or more questions proceed to the second part (from which the name derives), which contains six questions with the key words car, relax, alone, family/friends, forget, trouble, used to assess the need for further input.... crafft screening test

Malnutrition Universal Screening Tool

see MUST.... malnutrition universal screening tool

Neonatal Screening

*screening tests carried out on newborn babies to detect diseases that appear in the neonatal period, such as phenylketonuria (see Guthrie test). If these diseases are detected early enough, treatment may be instigated before any irreversible damage occurs to the baby.... neonatal screening

Prenatal Screening

*screening tests carried out to estimate the risk of chromosomal or other abnormalities being present in a developing fetus. They include blood tests to measure levels of *human chorionic gonadotrophin (hCG), *PAPP-A, *alpha-fetoprotein (AFP), inhibin (see activin), and *unconjugated oestriol (uE3) (see also triple test) and also ultrasound scanning for the presence of soft markers (see ultrasound marker; nuchal translucency scanning). If the results indicate a high risk of abnormalities being present, a diagnosis may be confirmed by more invasive procedures (see prenatal diagnosis).... prenatal screening

Uk National Screening Committee

(NSC) the body responsible for advising the NHS, the ministers of the UK government, and the three devolved governments in the UK about all aspects of screening. The NSC also has responsibility for overseeing all noncancer screening programmes in the NHS in England and monitoring their quality and effectiveness. It was formed in 1996 and became part of *Public Health England in 2013. See screening test.

National Screening Committee website: contains detailed notes on all screening programmes the committee has considered and the rationale for the decisions the committee has made... uk national screening committee

X-ray Screening

the use of an image intensifier to produce *real-time imaging during an X-ray examination on a TV monitor. It is widely used in angiography and *interventional radiology to guide procedures. See videofluoroscopy.... x-ray screening



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