Cervical cancer screening is one of the most effective ways to prevent cervical cancer or detect it at a very early and treatable stage. It is based on simple tests that look for changes in the cells of the cervix and for the presence of high risk types of human papillomavirus (HPV).
Many women feel anxious about Pap smears and pelvic exams. Understanding what the test is, why it matters and what to expect can make the experience easier and help you keep a regular screening schedule.
Dra. Joana Faria offers cervical cancer screening as part of prevention focused gynecology visits, with explanations in Portuguese, English, French, and Spanish.
What it is
Cervical cancer screening is a group of tests that check the cells of the cervix and, in many cases, test for high risk HPV. These tests can detect precancerous changes long before they turn into cancer.
The two main tools are:
- Pap smear which looks at the cells of the cervix under a microscope to see if there are any abnormal changes.
- HPV test which detects high risk types of human papillomavirus that are associated with cervical cancer.
Depending on your age, history and national recommendations, you may have Pap smear alone, HPV testing alone or both together at specific intervals.
Main symptoms and when to worry
Cervical cancer screening is usually done when you feel completely well. The goal is to pick up changes before symptoms appear. However, certain signs should prompt you to seek medical advice as soon as possible, even if your last test was normal.
You should book a consultation if you notice:
- Bleeding after sexual intercourse
- Bleeding between periods or after menopause
- Unusual vaginal discharge, especially if it is persistent or has a strong odor
- Pelvic pain that does not improve or keeps coming back
These symptoms do not mean that you have cervical cancer. Many benign conditions can cause them. But they are a reason to be examined and to discuss whether screening or further tests are needed.
If you have very heavy bleeding, severe pain or feel acutely unwell, you should contact emergency services or go directly to the nearest emergency department.
Diagnosis: exams and what to expect
A Pap smear and HPV test are usually quick. The whole consultation takes longer, because there is time for discussion before and after the exam.
During cervical cancer screening you can expect:
- Conversation before the exam
You will talk about your menstrual cycle, sexual history, previous Pap smear or HPV results, pregnancies and any symptoms you might have. - Pelvic exam with speculum
The doctor gently inserts a speculum into the vagina so that the cervix can be seen. You may feel pressure, but it should not be painful. - Collection of samples
A small soft brush is used to collect cells from the cervix. This usually takes only a few seconds. The sample is then sent to the laboratory for Pap smear and, when indicated, HPV testing. - Additional exams if needed
Depending on your history, a full gynecologic exam and ultrasound may be done in the same visit.
You can breathe slowly and let your pelvic muscles relax during the exam. If you feel pain or intense discomfort, tell the doctor so that the position or instruments can be adapted.
Treatment options and follow up
Most Pap smear and HPV results are reassuring and simply lead to a recommendation about when to repeat screening. When there are changes, they are often mild and can be monitored.
Depending on your results, follow up may include:
- Repeating Pap smear or HPV testing after a certain interval. Dra Joana will always recommend the interval to be used.
- Colposcopy, which is a more detailed examination of the cervix using a special microscope
- Targeted biopsies of areas that look abnormal on the cervix
- Treatment of precancerous lesions when needed, for example with local procedures that remove or destroy the affected area
The goal is to treat precancerous changes before they progress, while preserving as much healthy tissue as possible and taking into account your plans for future pregnancies.
All decisions about follow up and treatment are based on the type of abnormality, HPV status, your age and reproductive wishes. Your doctor will explain the benefits and possible risks of each option.
How Dra. Joana Faria approaches cervical screening in practice
Dra. Joana Faria is aware that many women delay Pap smears because of fear, shame or previous bad experiences. Her approach is centred on information, comfort and continuity.
In practice she:
- Explains in simple language what the Pap smear and HPV test look for and what they cannot detect
- Takes time to answer questions before starting the exam
- Performs the exam gently, warns you before each step and adapts the technique to your comfort
- Provides clear written reports and guidance about when to repeat screening
- Offers follow up in several languages so that you fully understand any abnormal result and the next steps
For many women, a respectful and well explained experience helps transform cervical screening from something they avoid into a regular part of their preventive care.
