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Abnormal Pap and Cervical Dysplasia

Tharani Ravi, MD, Fozia Akhtar Ali, MD and Jeremy Golding, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Cervical dysplasia: premalignant cervical disease that is also called cervical intraepithelial neoplasia (CIN); precancerous epithelial changes in the transformation zone of the uter...

DIAGNOSIS

HISTORY

Usually asymptomatic until there is invasive disease. Patients may present with vaginal discharge, abnormal vaginal bleeding, postcoital bleeding, pelvic pain, cervical mass, or bladd...

TREATMENT

ASCCP guidelines: Evidence-based management algorithms guide Pap smear and postcolposcopic diagnostics and therapeutics are available online at http://www.asccp.org/asccp-guidelines (7). 

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

After treatment (excision or ablation) of CIN II or III, women may reenter routine screening only after negative cotesting between 12 and 24 months. Screening sho...

REFERENCES

1
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin.  2018;68(1):7–30. [View Abstract on OvidMedline]
2
Markowitz LE, Gee J, Chesson H, et al. Ten years of human pa...

ADDITIONAL READING

American Society for Colposcopy and Cervical Pathology. Management guidelines. http://www.asccp.org/asccp-guidelines. Accessed January 5, 2018. http://www.asccp.org/asccp-guidelines...

CODES

ICD10

  • R87.619 Unspecified abnormal cytological findings in specimens from cervix uteri

  • N87.9 Dysplasia of cervix uteri, unspecified

  • N87.1 Moderate cervical dysplasia

  • N87.0 Mild cervical dysplasia

  • D06...

CLINICAL PEARLS

  • HPV is present in virtually all cervical cancers (99.7%), but most HPV infections are transient.

  • Vaccine should be offered prior to onset of any sexual activity for maximum effectivenes...

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