The Pap smear is the most important diagnostic procedure for detecting cervical dysplasia. It is a simple and painless test that may cause minor discomfort.
Normal vaginal discharge contains cells that are shed from the cervix and uterus. A gynecologist or other health care practitioner removes some of these cells by brushing or scraping the cervix with a small instrument designed for this purpose. The cells are placed on a glass slide and sent to a laboratory, where they are examined under a microscope for changes and abnormalities.
The Pap smear is not 100% reliable. It produces incorrect results in about 15-25% of cases. Cervical cancer is missed in about 5% of cases. Reasons for incorrect results include the following:
- Human error (The test should be done by an experienced practitioner and sent to a reputable laboratory.)
- Inadequate number of cells in the sample
- Presence of menstrual blood in the sample
- Temporary changes in cervical cells caused by medications, pregnancy, infection
If atypical cells are found, the physician may recommend further testing.
HPV Test
Because of the association between HPV and cervical cancer, this test can help determine the next step for a woman with atypical cells. This test checks for HPV genetic material, or DNA, within the cervical cells. A swab of cervical cells is taken and the specimen is sent to a laboratory and examined for HPV. If the HPV test is positive for a high-risk strain, the lesions are more likely precancerous. If the test is negative, the cervical changes are more likely benign.
Colposcopy
Depending on the severity of the dysplasia, results of the HPV test, and other risk factors, colposcopy is the next step in the diagnostic process. Generally, a colposcopy is performed if the cervical cells are distinctly abnormal.
This relatively simple procedure takes about 10 to 15 minutes to perform. A solution of diluted acetic acid (vinegar) is applied to the cervix to remove mucus and highlight abnormal cells. Using a bright light and a special electronic microscope (called a colposcope), the physician is able to see small areas of the cervix and vagina. The acetic acid and the lens of the colposcope make abnormal cells appear white and normal cells appear pink. If abnormal cells are seen, a biopsy is usually done.
Biopsy
A cervical biopsy usually is performed when the colposcopy reveals abnormal tissue. Using a small biopsy forceps, a tiny sample of abnormal tissue is removed from the cervix and sent to a laboratory for examination. More than one sample may be taken, depending on the amount of abnormal tissue detected by colposcopy.
Another type of biopsy, called an endocervical cutterage, may also be done. This procedure is performed if the physician is unable to determine if the abnormal cells go beyond the surface of the cervix. Using a small-spoon shaped instrument called a curette, cells from inside the cervix are biopsied. The procedure takes about 10 to 15 seconds, but it can trigger uterine cramping.
A procedure called dilatation and curettage (D & C) may be performed if the physician suspects that abnormal cells extend beyond the cervix. A curette is used to remove cells from the cervical canal and the lining of the uterus. This procedure requires local anesthesia.
Abnormal Pap Smears - Treatment is based on the biopsy results.
Credit: Women's Health Channel
Abnormal Pap Smears - Abnormal Pap Smear - Diagnosis - Links
Abnormal pap smear: cervical dysplasia, and treatment of abnormal ...
Answers about your abnormal Pap smear. Very few experiences can be as frightening
as receiving a call that your pap smear came back abnormal.
Pap smear diagnosis of endometrial cancer
... were read within 1 year of the diagnosis of endometrial ... that almost half the patients
had a abnormal Pap. More importantly, if the Pap smear was suspicious
Answers to FAQs and Articles about Cervix and Pap Smear Problems ...
... recommended that you see a physician for diagnosis of secondary ... actually on the cervix
can be more abnormal (more severe) than the PAP smear suggests
Abnormal Pap Smear: hpv human papillomavirus, cervical dysplasia
... Chapter 4: Follow-Up and Treatment of Abnormal Pap Smears Chapter 5: The Problem
Pap Smear Chapter 6: Cervical Cancer: Dealing with the Diagnosis Chapter 7
Abnormal Pap Smear: hpv human papillomavirus, cervical dysplasia
... What words are used to diagnose abnormal Pap smears and what do they mean? What
does "ASCUS" mean? Does a diagnosis of "atypical" on my Pap smear mean I have ...
Abnormal Pap Smears, What Every Woman Needs to Know
... Reviews Book Description You have just received an abnormal Pap smear diagnosis,
joining the ranks of the close to 4 million women annually who receive one.
MEDLINEplus Medical Encyclopedia: Pap smear
... If you have never had an abnormal Pap smear before, and the ... If you have had an abnormal
Pap test in the past ... to top The following drugs may affect the Pap smears
Pap smear terminology common causes of abnormal Paps
... tool for further evaluation of abnormal Pap smear results. Cervical Cancer Resources
for understanding risk factors, symptoms, diagnosis, and treatment options
Abnormal Pap smear of the Uterine Cervix at BMA General Hospital
Abnormal Pap smear --Colposcopic diagnosis and biopsy
Screening and Diagnosis of Cervical Cancer
Screening and Diagnosis of Cervical Cancer ... While patient management protocols are
well-defined for the normal and abnormal Pap smear, the follow up of an ASCUS
