In an effort to decrease the occasional false negatives in the pap smear and further increase the screened population, thinprep pap test tp, a fluidbased cytology collection method, has been developed. Conventional pap smear and liquid based cytology for. The pap smear has brought about a dramatic improvement in the prevention of cervical cancer in women worldwide. In the united states, its incidence and mortality is well below that of breast, lung, endometrial, colon, and ovarian cancer. Gynecological cytology specimens pap smear thinprep pap. The pap smear has remained the foundation for cervical cancer screening for over 70 years. Pap smear testing australia introduced a national cervical screening program in 1991, which involved a papanicolaou pap smear test every two years examining cervical cells microscopically i.
This monograph essentials of pap smear and breast cytology is prepared at the request of a large number of students in cytology who wish to have a small and concise book with numerous illustrations for easy reference during their laboratory training. After fixation and staining, each smear was carefully examined. Acog announces new pap smear and cervical cancer screening guidelines the american congress of obstetricians and gynecologists announced that women should have their first pap smear screening at age 21 and can be rescreened less frequently than previously recommended. Colposcopy and biopsy was carried out in 45 cases with abnormal cytology either on pap spin or conventional pap smear. Edited by frappart l, fontaniere b, lucas e, sankaranarayanan r.
Printable copy pdf file of the complete article 323k or click on a page image below to. The advantages of diagnostic cytology are that it is a noninvasive, simple procedure, helps in faster reporting, is relatively inexpensive, has high population acceptance and facilitates. Alternatives to the traditional papanicolaou pap smear liquid. As the drawing shows, the cervix is the lower, narrower part of the uterus. Cervical cancer knowledge for medical students and. Label a surepath collection vial with the required identifiers and complete a. Most information and illustrations in this book are extracted from the authors. Cytology the pap smear is a screening test designed to aid in the detection of premalignant and malignant conditions of the uterine cervix. The pap smear is used to sample the female genital trac t for presence of cellular change s which may indicate cervical or uterine carcinoma or their precursors. This site is like a library, use search box in the widget to get ebook that you want. Screening cessation a woman may discontinue screening at age 70 if she has an adequate and negative cytology screening history in the previous 10 years. Y o u ca n p os iti cytology pap smear collection vial. The pap smear is a screening test and should not be used as the sole means of detecting cervical cancer.
The test may also detect infections and abnormalities in the endocervix and endometrium. Cytomorphological analysis of cervical cytological smears of women. The current reporting system is the bethesda system, which was introduced in 19886 and later updated again in 1999 table 1. It is valuable for detecting precancerous cells and lesions, which are simpler to treat than invasive cancer. Cytology results were reported in accordance with the bethesda system 2001. There are two main types of pap tests, the conventional pap and the liquidbased cytology pap test. Populationbased cohort study assessing the efficacy of. If a womans pap smear result is normal, she will continue routine screening. If used in pregnancy the collection technique should be modified see below.
Cytology pap smeargynecological specimen principle. The high specificity means that cytology correctly identifies a high proportion of women who do not have high grade lesions or cancer. Infection by highrisk hpv types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 may be associated with precancerous lesions or cancer of the cervix. Siobhan bourke discusses and demonstrates correct technique for taking cervical samples. Pap tests with unsatisfactory interpretations are not appropriate for hpv testing. Whether the pap smear is an adequate sample incidental findings such as evidence of infection evidence of lesions. The paptest pap smear, papanicolaou test is a screening test used in gynecology. Abnormal vaginal cytology is seldom of clinical importance. Cervical cancer screening guidelines for averagerisk women. Cancer is a disease in which cells in the body grow out of control. The mortality and incidence of cervical cancer have significantly declined after the introduction of routine papanicolaou pap smear screening.
Gynecologic cytology laboratory practice and methodology. Pdf this overview is intended to give a general outline about the basics of cytopathology. If liquidbased cytology lbc is being used, screening can be extended to every 2. The following outline is a brief reference to the information thatwill be contained in the cytology report. A pap smear, also called a pap test, is a routine screening procedure for cervical cancer.
The internal orifice of the uterus is an interior narrowing of the uterine cavity. T y p e a q u ot e fr o m th e d o c u m e nt or th e su m m ar y of a n in te re st in g p oi nt. The uspstf recommends screening for cervical cancer in women aged 21 to 65 years with cytology papanicolaou smear every 3 years or, for women aged 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and hpv testing every 5 years. The test mainly examines the cervical smear for cervical dysplasia or precancerous changes. It is important to sample the cervix or vagina well. This time is necessary for searching and sorting links. Pap smear and breast cytology pathology university of british. It may be followed by other tests like a pap for triage. Most low risk women younger than 30 years old should undergo pap smear cervical. Educational curricula for cytomorphology criteria, laboratory methodologies, and quality assurancequality control processes learned over the years from the pap test form a foundation on which the rest of cytopathology expands. Liquidbased cytology versus conventional cytology for. Specimens may be submitted as conventional smears, although the. If the pap smear result is abnormal, the doctor will recommend repeat testing or more frequent followup, depending upon the exact type of abnormality and whether any infection is present. Today, papanicolaou pap testing is the primary screening for cervical cancer.
The absence of transformation zone is not a reason to repeat a pap test earlier than the recommended interval. Uniform guidelines for cervical cancer screening in flanders. Scrape base and sides of vesicle with a sterile metal spatula or scalpel. With advancements in molecular diagnostics, primary highrisk human papillomavirus hrhpv screening has recently become an accepted standalone or cotest with conventional cytology. Ppap smear reportingap smear reporting the pap smear reporting classification has evolved and been refined over time.
A pap smear also known as the pap test is a medical procedure in which a sample of cells from a womans cervix the end of the uterus that extends into the vagina is collected, processed and stained. Cervical cytologic smears in pap solution vs thinprep. A cytology report recorded as suspicious is not considered as diagnostic of cancer and unless supported by a positive biopsy as reported on a pathology report or by a clinical impression of cancer, these cases should not be abstracted the papanicolaou classification of cells for the detection of malignancy pap smear used in the past is as follows. Its recommended once every three years for women starting at age 21, regardless of whether or not you. The specific cytological abnormality that led to the colposcopic examination, this is usually the most recent pap smear prior to the actual colposcopic examination. The bethesda system is now used to interpret pap smear findings. Prevalence of unsatisfactory pap smear and associated. Pdf cytopathological pattern of cervical pap smear according to. Cervical cancer basic facts on screening and the pap test what is cervical cancer. The study used a hospital based registry which has a catchment that covers the entire southern part of ghana and beyond without any welldefined population. Abnormalities would lead to further investigation by a specialist and generally. A breviary of cytopathology is relatively much more compactbut is still exhaustive. Proper collection and preparation of the specimen is imperative for adequate study and interpretation of the specimen.
Click download or read online button to get the smear pdf book now. Pap test collection guidelines for cytologic examination acceptable specimens for the pap test include cervical, cervical and vaginal, endocervical, vaginal andor vulvar scrapings or brushings. The pap test and bethesda 2014 fulltext acta cytologica 2015. This order is totally independent of the cytology results of the pap test. Epithelial cell abnormalities were found in 5% smears, atypical squamous cells of. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
Papanicolaou test also called pap smear, pap test, cervical smear, or smear test is a screening test used to detect potentially precancerous and cancerous processes in the the endocervical canal transformation zone of the female reproductive system. Detection of abnormal cervical cytology in papanicolaou smears. Screening programs office manual for health professionals with permission. The conventional pap slide smear and the newer liquidbased cytology use similar technologies in examining cervical cells for abnormality. Pap smear test is done a week or two weeks after the end of the menstrual period. Cytology specimen collection and processing gynecological cytology specimens pap smear thinprep pap test principle a gynecological cytology specimen pap smear is an evaluation for the presence of abnormal cells, which may be indicative of malignancy or other conditions requiring treatment. The papanicolaou test abbreviated as pap test, also known as pap smear, cervical smear, cervical screening or smear test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix opening of the uterus or womb or colon in both women and men. Discontinue if three negative pap smear results or two negative hpv test results in past 10 years, if most recent test was within the past five years. Cervical cytology became the standard screening test for cervical cancer and premalignant cervical lesions with the introduction of the papanicolaou pap smear in 1941. In the conventional pap test or smear, the samples are swabbed and then smeared directly onto a microscope slide after collection. This guideline on the collection of a papanicolaou smear completes a series of earlier published instructions on uniform cytology reporting and followup of screenpositive lesions, whichwere formulated by the working group on uniformity in cervix cytology wucc, 1996 and the followup working group arbyn, 1996. The aim of this study is to evaluate the abnormal cytological entities. Primary hrhpv testing is defined as a standalone test for cervical cancer screening without concomitant cytology testing. Pap smear and p ap stain was named, was one of the initial.
This test specifically identifies hpv 16 and hpv 18, while concurrently detecting 12 other types of high risk hpvs. Most pap smears are taken by gps, while some samples are taken by gynecologists. Pamlpshmc cytology uses the bethesda 2001 reporting system for all gyn samples. The cervical screening program has a coverage of 60% after 3. Histopathology and cytopathology of the uterine cervix digital atlas. Liquidbased, thinlayer preparation of cervical cytology specimens was a subsequent modification in technique.
Gyenocologic pap test collection procedure medical. Screening programs using conventional cytology conventional pap smear cps have successfully reduced cervical cancer, but newer tests like liquidbased cytology lbc and human papillomavirus testing might enhance screening. Chlamydia testing using floq and uriswabs is also discussed. Every chapter has been updated to provide the latest necessary information on scientific advances. The history of the bethesda system for reporting cervical cytology goes back almost 3 decades. It has inherent false negative and false positive results and should not be used as the sole means of detecting cervical cancer. Pdf cervical carcinoma is an important womens health problem worldwide. The cytopathology report will indicate in the notes section whether or not hpv has been ordered and if sufficient andor acceptable specimen exists to perform hpv testing. Pap smears, cytology and cchc lab work and follow up. Main purpose of the test is to detect precancerous lesions called squamous intraepithelial lesion sil, which are often caused by sexually transmitted human papillomaviruses. Cells are scrapped or brushed by a qualified physician, physicians assistant, nurse, or. The main aim of the present study was to assess the diagnostic accuracy of lbc versus cps using split samples. The papanicolaou test abbreviated as pap test, known earlier as pap smear, cervical smear, or smear test is a method of cervical screening used to detect. When these abnormal cells are present in the cervix, it is called cervical cancer, or cancer of the cervix.
The doctor may choose to do a procedure known as a colposcopy. Press button download or read online below and wait 20 seconds. To evaluate the cytomorphological profile of cervical smears in patients. Cervical cancer is the third most common type of gynecological cancer amongst us women. Cervical cancer basic facts on screening and the pap test. Download the smear pdf or read the smear pdf online books in pdf, epub and mobi format. Liquid based pap surepath pap collection instructions using the cervexbrush note.
Management algorithms for abnormal cervical cytology and. The norwegian cancer registry sends a reminder to women without a pap smear after three years and a new reminder after four years. Interpretation of results pap test report view in chinese. In cervical cancer screening, cytology includes a method to smear cells directly on a glass slide using a sampling device, referred to as conventional cytology sampling and liquidbased cytology to stir a sampling device in a cell fixation solvent in a suspension.