Ovarian cancer and Pap test

Before we discuss the effectiveness of Pap test in the detection of ovarian cancer, let us take a look at what a Pap smear entails. A Pap smear, also referred to as the Pap test is basically a medical test used generally for detecting cervical cancer in women. In this medical procedure, a group of cells is collected from the cervix or the lower end of the uterus which extends in the vagina and smeared or spread over a microscopic slide. An examination of the cells is done through a microscope to find pre-malignant or malignant changes.

A Pap smear is no doubt a quick, simple and comparatively painless screening examination. Its "specificity" is good, though not perfect. Specificity refers to the ability of avoiding classification of a normal smear as an abnormal one. The Pap smear has a sensitivity which is also good though not foolproof. There have been cases where women have developed cervical cancer in spite of going through frequent Pap screening.

Ovarian cancer - an overview

Ovarian cancer refers to malignancy or cancer in the ovary, which is the egg producing sac for the females. Ovarian cancer is regarded as the seventh most commonly occurring cancers in women residing in the United States. More than 25,000 women are freshly diagnosed every year with ovarian cancer.

Ovarian cancer is actually a representation of a group of several tumors which grow from different kinds of tissues found inside the ovary. There are different forms of ovarian cancers. The most common form of ovarian cancer is the epithelial cells cancer developing on the external portion of the ovary. Other types of ovarian cancer include cancer developing from the germ cells within the ovary or from stroma (the supporting tissue) of the ovary.

Ovarian cancers are often diagnosed at a late stage when the cancer has spread. It had been commonly believed till recently that ovarian cancer is unrecognizable since there are no early symptoms. However, the American Cancer Society has in June 2007 released a statement with regard to the probable early symptoms of ovarian cancer. These include pelvic and abdominal pain, bloating, frequent urination and feeling of fullness very quickly after eating.

Is ovarian cancer detectable through a Pap smear?

A Pap test cannot effectively diagnose ovarian cancer. The Pap test just collects cells which are scraped from the uterine cervix. In rare cases ovarian cancers are diagnosed through Pap tests and these generally are at a very advanced stage. Unfortunately, no routine or standard screening test to detect ovarian cancer has been developed so far. Researchers till date have not been unanimous in their opinions over a specific screening tool which is adequately sensitive for detecting ovarian cancer in the early stages. These tools are also not effective in helping distinguish between ovarian cancer and different other noncancerous conditions.

Doctors generally do not advise women for routine screening who run an average risk for ovarian cancer. For women with high risks, experts have diverse opinions with regard to the techniques for screening, as well as the appropriate time to do it. You should discuss the risks as well as the benefits of the different screening tests with the healthcare professional.

Although the Pap test is not useful for detecting ovarian cancer, it can detect cancerous cells which migrate from the ovaries to the uterine cervix or the presence of abnormal cells within the uterine cervix.

Two forms of tests for detecting ovarian cancer are generally recommended. These are transvaginal sonography and CA-125 which are commonly offered to high-risk women with a strong family medical history. Transvaginal sonography refers to an ultrasound examination wherein a tiny instrument is placed into the vagina in order to detect any mass inside the ovary. However, it is not effective in diagnosing whether the masses are cancerous or not.

CA-125 refers to a protein test. There is a higher content of this protein within the blood in women suffering from ovarian cancer. An inherent problem with this test is that apart from cancer, different other conditions can also be responsible for causing higher levels of this protein in the blood. Consequently, the test cannot determine for sure whether the person is affected with ovarian cancer or not. Additionally, a person afflicted with ovarian cancer may still retain a normal level of CA-125 in the blood.

It can be said that a pap test identifies minor cell abnormalities prior to them becoming malignant, at a juncture when the severity of the condition is not that great and is easily treatable. Pap test cannot detect ovarian, vaginal and uterine cancers. It is only effective to an extent in diagnosing cervical cancer. Cancer of the ovaries, uterus and the vagina can be discovered during a gynecologic or pelvic exam that is usually done along with the Pap smear.