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Cancer Screening: Cervical Cytology Updated 5/2008

Michelle Berlin, MD, MPH
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BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • Associated Conditions

DIAGNOSIS

  • Tests
  • Differential Diagnosis

TREATMENT

  • General Measures

Ongoing Care

  • Disposition
  • Prognosis
The following is an excerpt....
BASICS
Description
  • "Pap test" or "Pap smear" is entrenched in medical terminology and frequently is used to refer to cervical cytology regardless of actual method used to obtain or process the cytology, either by conventional slide or liquid based technology.
  • Cervical cytology, using the Pap smear, is a screening test for premalignant cervical dysplasia and cervical cancer:
    • Designed to have high sensitivity (detection of cases)
    • Need for further evaluation determined by result
    • 2006 TBS guidelines current: www.asccp.org
  • Cervical dysplasia:
    • CIN—cervical intraepithelial neoplasia
  • ASCUS—atypical squamous cells of undetermined significance
  • ASC-H—atypical squamous cells, cannot exclude HSIL
  • LSIL—low-grade squamous intraepithelial lesion
  • HSIL—high-grade squamous intraepithelial lesion
Age-Related Factors
  • Differing recommendations
  • USPSTF:
    • Begin 3 ...

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Normal cervical Papanicolaou (Pap) smear. Large squamous cells from the superficial, and intermediate layers of the epithelium are illustrated. The cells have abundant cytoplasm, which varies in staining from pink to blue. The nuclei are small, and the nuclear-cytoplasmic ratio is low. The most superficial cells have pyknotic nuclei (arrows).Credit: Image from Rubin E MD and Farber JL MD. Pathology, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 1999.
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