Pap test: what really checks
The Pap test is a fundamental tool in the prevention of cervical cancer, but it cannot be used to exclude different pathologies.
“A Negative Pap test does not protect against the diagnosis of a tumor that grows higher, such as that of the endometrium» explains Martinelli. This is because the cell sampling takes place at the cervical level: any alterations of the endometrium may not be detected.
Endometrial cancer: the most frequent
Professor Fabio Martinelli
In our latitudes, endometrial carcinoma is the most frequent gynecological tumor, with around 10,000 new cases every year. It hits predominantly women in menopausewith an average age of around 60, and To date, there is no real screening program like for cervical cancer.
For this reason, early diagnosis passes above all throughpay attention to the signs.
The symptom not to be ignored
The main alarm bell is one: bleeding. «Endometrial cancer often manifests itself with blood loss, especially after menopause», underlines the expert. In many cases, it is precisely this signal that allows a early diagnosis: blood loss during menopause represents in fact one of the first alarm bells that lead women to carry out tests and identify carcinoma in its initial stage.
Not all bleeding is linked to a tumor – it can also depend on drugs, such as anticoagulants, or other conditions – but it is always essential to investigate it.
The correct tests when there is a suspicion
In the presence of symptoms or doubts, the diagnostic process follows precise steps.
The first exam is thetransvaginal ultrasoundwhich allows you to evaluate the thickness of the endometrium. If it is increased, we proceed with one biopsythe only test that allows a certain diagnosis. «It’s there biopsy that confirms or excludes the presence of the tumor» explains Martinelli.
What happens after the diagnosis
Once diagnosed, the tumor is studied to see if it is limited to the uterus or if it has spread. In approximately 80% of cases, surgery is curative: provides for theremoval of the uterus, ovaries and sentinel lymph nodes. If the disease is more advanced, other treatments such as radiotherapy, chemotherapy or immunotherapy can be associated.
Risk factors to know
Some conditions increase the risk of developing endometrial cancer and require increased attention.
Among these:
«In women with Lynch syndrome the incidence is higher and more careful surveillance is proposed», specifies Martinelli. Lifestyle also plays an important role: the weight control and thehormonal balance they are key elements in prevention.
Hormone replacement therapy: what to know
An often discussed topic concerns hormone replacement therapy (HRT). The older, unbalanced formulations could increase the risk. Today, however, balanced therapies do not show the same effect. «It is not prohibited, but must be evaluated on a case-by-case basis, discussing the risks and benefits», explains the expert.
The importance of specialized centers
Another crucial aspect concerns where you are treated. «The data shows that the patients followed in reference centers have a greater life expectancy”underlines Martinelli. The quality of the surgical approach and multidisciplinary management make the difference in the treatment path.
The Pap test remains a fundamental tool, but it is not enough to exclude all gynecological pathologies. Listening to your body, recognizing the signs – such as blood loss during menopause – and turning to specialists are the real prevention tools. Because, especially in the case of endometrial cancer, early diagnosis comes first and foremost from awareness.
