How Is Cervical Cancer Diagnosed, Part 2

Cancer |

Abnormal smears are divided into three categories:

Atypical squamous or glandular cells of undetermined significance, or ASCUS/AGUS, which are mildly abnormal cells on the surface of the cervix.
Low-grade squamous intraepithelial lesions, or LGSIL, which include human papilloma virus changes and mild dysplasia.
High-grade squamous intraepithelial lesions, or HGSIL, which include moderate dysplasia, severe dysplasia and carcinoma in situ.
These terms have markedly increased the number of Pap tests reported as “abnormal.” Most often with ASCUS/AGUS and LGSIL findings, the doctor will repeat the Pap test in three to six months, since many of these cases will revert to normal. However, if the repeat results are still abnormal, the woman should be advised to undergo colposcopy. (more…)

How Is Cervical Cancer Diagnosed, Part 1

Cancer |

The Pap Test

Cervical cancer is usually diagnosed by direct observation of the cervix in women who are symptomatic. However, the primary method of detection is still the Pap test, which is now considered a routine part of a woman’s annual physical exam.
The healthcare provider first looks at the vaginal area to see if there are any signs of infection. The provider slides a speculum, which is a thin piece of plastic or metal that looks like a duckbill, into the vagina so he or she can look at the upper part of the vagina and the cervix directly. Then a small wooden or plastic spatula is inserted into the vagina. Several layers of cells are scraped off the cervix and placed on a slide to be looked at under a microscope.

Next, a cotton-tipped swab or soft brush is inserted deep into the canal of the cervix that leads to the uterus, where precancerous lesions and cervical cancers can develop. This sample is placed on the same slide or a second slide, or with more recent technology, put into a fixative solution to be investigated.

After the Pap test, the healthcare provider should check the fallopian tubes, ovaries, uterus and rectum by putting two gloved fingers inside the vagina or rectum and using his or her other hand to feel from the outside for any lumps or tenderness. The whole exam takes only a few minutes and is usually completely painless, although some women will feel slight cramping.

Women should not have sexual intercourse, use vaginal creams or douche for 24 hours before the exam. Preferably, the Pap test should not be performed when a woman is having her period.

Describing Pap Test Results .

Pap test results are described in a new way called the Bethesda System. This new system was developed at the Bethesda Convention in 1987, which will meet for a third time to come up with the best way to provide information about Pap test results.

The outcome of the Bethesda Convention was the introduction of new terms, which allow the Pap smear test to be more specific. However, this can sometimes be confusing for patients and their healthcare providers.