Pap test with a transcript of the cytological examination of the smear. What is a pap test

Papanicolaou test- analysis to detect precancerous and cancerous diseases of the cervix. This study has many synonyms - Pap test, Pap smear, cytological smear. The Papanicolaou test was named after the author, physician and founder of medical cytology, Georgios Papanicolaou.

A Pap test is performed during a gynecological examination for all women over the age of 21. Using a spatula and endobrush, the doctor takes cell samples from the surface of the cervix and cervical canal. The resulting material is applied to a glass slide, fixed with alcohol and sent to the laboratory. Laboratory assistants stain the smear according to the method developed by Papanicolaou, study the structure of cells, paying special attention to the typicality, size, degree of maturation, size and structure of nuclei, their relationship with the cytoplasm.

Research value. The Papanicolaou test allows you to detect dysplasia and cervical cancer in the initial stages, while the disease responds well to treatment. Thanks to the massive Pap test over the past 40 years, it has been possible to reduce the incidence of cervical cancer by 60-70%, and the death rate from this type of cancer has decreased by 4 times.

Cervix

• exocervix or vaginal part - the lower segment of the cervix, which is in contact with the vagina;
• endocervix or cervical canal, which is also called cervical canal- this is a through hole that passes inside the body.

• internal os opens into the uterine cavity;
• external pharynx opens into the vagina.

• Epithelium- cells located on the surface of the mucosa;
• basement membrane- a thin plate of connective tissue, which is the basis of the mucous membrane.

• Basal- 1 layer of small undifferentiated(immature) cells lying on the basement membrane;
• Parabasal- 2-3 rows of cells in which the first signs of maturation appear;
• Intermediate– 6-12 rows of moderately differentiated cells;
• Surface- 3-18 rads of cells lying on the surface. They are not prone to keratinization and are constantly sloughing off, being replaced by new ones rising from the basal layer.

Indications for a pap test

• First smear at the age of 21 or 3 years after the onset of sexual activity.
• 1 time per year during a routine gynecological examination for all women from 21 to 64 years of age.
• 1 time in 2-3 years handed over by women under 65 years old, in whom 3 times in a row in a smear no changes were found in the structure of the epithelial cells of the cervix. After age 65, the test can be done less frequently.
• 1 time in 6 months- women of the following categories:

• women with menstrual irregularities;
• patients with cancer in the family;
• women with erosion, dysplasia or other diseases of the cervix;
• signs of human papillomavirus infection were found;
• to control the treatment of the cervix.

Pap test methodology

When is the best time to do a Pap test?

To take the material, the gynecologist uses disposable instruments:

• Eira spatula - for taking a smear from the vaginal part. Its narrow end is inserted into the external pharynx, and the short and wide end is scraped from the vaginal part;
• curettes - Volkmann's spoons - for taking scrapings from suspicious areas;
• endobranch brush - for scraping the epithelium inside the cervical canal.

How is a Pap test performed?

• The woman is placed in an examination chair. The doctor examines the cervix using gynecological mirrors.
• Cleansing the cervix from mucus. carried out if a large amount of secretion prevents scraping.
• Material samples are taken from several sites:

• In the area of ​​​​the external pharynx, where precancerous and cancerous cells most often appear;
• On visible foci of pathological changes, if any;
• From the inner surface of the cervical canal. This procedure is carried out after the removal of the mucous plug.

• The resulting material from each area is applied in an even layer on separate glass slides, touching all surfaces of the brush. Smears are fixed with fixative solutions containing alcohol. This is necessary to avoid their drying out and deformation.
• The glasses are marked (signed), a referral containing brief information about the patient is attached to them.
• In the laboratory, the samples are stained to better see the structural features of the cells. Conduct microscopy of samples. It evaluates:

• cell type;
• the size;
• the presence of inclusions in the cells;
• their degree of maturity;
• the number and structural features of cell nuclei;
• the state of the cytoplasm;
• ratio of cytoplasm to nucleus.

• The result of the pap test is usually sent to the attending physician in 1-2 weeks. In private laboratories, the waiting time for a Pap test result is 1-3 days.

Pap test based on liquid cytology used in modern laboratories is considered more informative. The technique makes it possible to obtain a high-quality cytological preparation and excludes the destruction of cells during drying and fixation on a glass slide. If necessary, you can prepare several more preparations if the first one was unsatisfactory, and conduct additional studies to determine the human papillomavirus or identify markers of proliferation (pathological cell division).

Methodology for conducting a pap test based on liquid cytology:

• The brush makes 5 rotational movements clockwise in the region of the external pharynx. Thus, it is possible to make a scraping from the entire transformation zone. With another brush, material is collected from the walls of the cervical canal.
• The tips of the brushes are removed and placed in separate vials with preservative liquid.
• The tube is shaken, as a result of which the cells pass into the liquid.
• In the laboratory, the liquid is centrifuged. Preparations are prepared from the resulting cell sediment, stained and examined under a microscope.

How to prepare for the pap test?

• sexual contacts;
• douching;
• vaginal preparations - creams, suppositories, spermicidal gels;
• washing inside the vagina and vaginal shower;
• hot bath.

• during menstruation;
• during inflammatory diseases of the cervix.

What are the results of the pap test?

• System developed by Papanicolaou in 1954, which classifies changes into 5 classes:

• Class I - normal cytological picture, unchanged cells;
• Class II - minor cell changes associated with the inflammatory process in the vagina and cervix;
• Class III - suspicion of a malignant formation, single cells with an anomaly in the structure of the nucleus and cytoplasm;
• Class IV - single cells with obvious malignant changes;
• Class V - a malignant tumor, a large number of cancer cells.

• System proposed by the US National Cancer Institute in 1988. It was revised in 2001 and is now widely used in all countries.

• NILM– absence of signs of malignancy and epithelial damage;
• ASCUS- atypical squamous epithelial cells of an indeterminate nature. May indicate inflammation, but neoplasia (a precancerous condition that can transform into a malignant tumor) is not ruled out;
• ASC-H- atypical squamous epithelial cells. It is impossible to exclude the defeat of the squamous epithelium of a high degree of severity - HSIL;
• LSIL- damage to the squamous epithelium of a low degree of severity. Indicate weak dysplasia or damage by human papillomavirus;
• HSIL- damage to the squamous epithelium of a high degree of severity. May indicate moderate or high grade dysplasia, rarely carcinoma in situ;
• AGC- atypical glandular cells, atypical cells of the glandular epithelium of the cervical canal;
• AGUS- abnormal glandular cells of uncertain significance;
• Carcinomain situ- the beginning of the formation of a cancerous tumor, the cells do not go beyond the basement membrane;
• High Grade SIL squamous cell carcinoma- a large number of malignant cells, which indicates cancer based on squamous epithelium;
• Adenocarcinoma- cancer based on columnar epithelium.

Pap test result options

• unchanged squamous epithelial cells;
• cells of cylindrical and metaplastic epithelium;
• leukocytes in a small amount;
• bacteria in small quantities.

• dysplasia;
• human papillomavirus (HPV) infection;
• chlamydia and other sexually transmitted infections;
• mucosal atrophy during menopause.

• undergo an analysis for the detection of papillomavirus (an analysis for HPV);
• retake the pap test after 1 year.

• dysplasia;
• papillomavirus infection.

• test for HPV
• colposcopy, if HPV is detected,
• conduct PAP in a year.

• precancerous changes - dysplasia of 2-3 degrees;
• rarely, the initial form of cancer.

• mandatory extended colposcopy.

4.HSIL-. A large number of atypical cells indicating the 2nd and 3rd degree of dysplasia. In 2% of women with HSIL is detected as cancer. Without treatment, in 7% of women within 5 years, dysplasia transforms into cancer.
The reasons:

• high-grade dysplasia;
• rarely, cervical cancer.

• if the examination reveals first-degree dysplasia, then a pap test and colposcopy are performed every 6 months for 2 years;
• women over 25 years of age immediately undergo a diagnostic excision - removal of a section of the mucous membrane of the cervix.

• dysplasia of 1-3 degrees;
• cervical cancer;
• endometrial cancer.

• colposcopy;
• collection of material by scraping the mucous membrane of the cervical canal;
• analysis for HPV;
• women over 35 years of age with irregular spotting - collection of material by scraping the endometrium.

• high-grade dysplasia;
• cervical cancer

• colposcopy;
• diagnostic curettage of the cervical canal;
• scraping the endometrium for diagnostic testing;
• diagnostic excision - removal of a section of the mucosa.

• endometrial hyperplasia - precancerous changes in the endometrium;
• endometrial cancer;
• in the absence of symptoms (irregular menstruation, spotting from the vagina, not related to menstrual bleeding) in women who have not reached menopause, benign glandular changes are considered a variant of the norm.

• diagnostic curettage of the endometrium in women who have reached menopause or who have symptoms of endometrial hyperplasia;
• there is no need for further evaluation in premenopausal women who are asymptomatic.

1. Repeat pap test in 3 months. If it turns out to be negative (without pathological changes), then repeated Pap tests after 6 months, 1 year, 2 years. With a positive result, a colposcopy is performed.
2. Perform a colposcopy. If an extended colposcopy does not reveal any changes, then repeat the Pap test after 6 or 12 months. If colposcopy has revealed foci of changes, then a biopsy is performed. If the result of colposcopy is doubtful, anti-inflammatory or estrogenic hormonal treatment is performed, and after it a second colposcopy is performed.
3. Get tested for human papillomavirus (HPV). If oncogenic types of the virus are detected, colposcopy is performed. In the absence of such, a repeated Pap test after 6 months.

Incorrect pap test result

1. False positive Pap test result- the analysis indicates that there is dysplasia, although the woman is healthy. The cause may be transferred inflammatory and infectious diseases of the genital organs, erosion in the healing stage (regeneration), hormonal disorders. These processes cause the appearance of cells that may have an unusual shape. To exclude errors, a colposcopy or a repeated pap test is performed.
2. False negative Pap test result- the disease is present, and the test results are within the normal range. This is possible if the doctor did the scraping incorrectly and epithelial cells from the foci of the disease did not get into the smear, or atypical cells were not found in the laboratory. This option is possible, but do not be afraid. If visible changes appear on the cervix, the doctor will prescribe a colposcopy and a biopsy. Even if the foci of dysplasia go unnoticed, it will take 2-20 years before they turn into a malignant tumor, and the pathology will be detected during the next PAP test.

1. Infections.Bacterial and viral infections are indicated by:

• squamous cells of uncertain significance ASC US;
• the presence of bacteria in the material;
• changes in the structure of cells caused by the presence of a virus.

• Inflammatory atypia - the appearance of cells with minor deviations (thin membranes, enlarged nuclei), which is caused by inflammation;
• Squamous metaplasia - replacement of the cylindrical epithelium with stratified squamous;
• Hyperkeratosis - keratinization of stratified squamous epithelium;
• Parakeratosis - increased keratinization or complete absence of the keratinization process;
• Reserve cell hyperplasia - an increase in the volume of reserve cells.

1. papillomavirus infection. The appearance of most atypical cells is associated with the human papillomavirus. Its presence in the body is indicated by:

• Atypical squamous cells of uncertain significance ASC US;
• Low-grade squamous intraepithelial lesions LSIL, disorders in squamous epithelial cells;
• Atypical squamous cells that do not rule out HSIL - ASC-H;

1. Neoplasia or dysplasia of the cervix abbreviated CIN (cervical intraepithelial neoplasia) - these are pathological changes in the cervical mucosa that occur when infected with the human papillomavirus. The virus damages the genetic material in the cell nuclei, which causes the appearance of abnormal cells and increases the risk of developing malignant cells. Mild dysplasias are able to regress (cure) on their own, but about 20% eventually progress to a more severe stage.

1. Carcinoma in situ(in situ) - cervical cancer at an early stage of development. Cancer is a collection of epithelial cells. It does not penetrate into the basement membrane and underlying tissues, does not form metastases. It responds well to treatment. About the development of the oncological process they say:

• High grade squamous intraepithelial lesions HSIL;
• Cells characteristic of cervical cancer - carcinoma in situ .

1. Adenocarcinoma - cervical cancer, which originates from the cylindrical epithelium - cells of the cervical canal. Adenocarcinoma is indicated by:

• Atypical glandular cells AGC;
• Adenocarcinoma cells in situ AIS.

1. Squamous cell carcinoma - a type of cervical cancer that is formed on the basis of squamous epithelial cells. The analysis reveals:

• Carcinoma in situ - AIS;
• Atypical squamous cells that do not rule out HSIL - ASC-H;
• High grade squamous intraepithelial lesions – HSIL;
• Atypical glandular cells - AGC.

1. Cervical cancer or endometrial cancer- a malignant tumor of the inner lining of the uterus. Cancer is indicated by:

• Atypical glandular cells AGC;
• Atypical squamous cells that do not rule out HSIL - ASC-H;
• High grade squamous intraepithelial lesions – HSIL;
• Cells characteristic of cervical cancer - AIS.

1. Benign glandular changes– endometriosis. About this disease they say:

• Benign endometrial cells;
• Endometrial stromal cells;
• Histiocytes are connective tissue cells.

What to do after pap test

To prevent infection of lesions on the cervix, it is recommended to refrain from:

• sexual contacts;
• douching and vaginal douche;
• use of tampons.

This study got its name from the Greek scientist Georgios Papanikolaou, a pioneer of cytology and early cancer detection. The PAP test helps to identify those cellular changes in the epithelium of the cervix, which can subsequently lead to cancer, and start treatment in a timely manner. Today, this analysis is used all over the world and has already saved the lives of hundreds of thousands of women.

How is a Pap Test Performed?

The sampling procedure is painless. It is carried out during the examination in the gynecological chair. First, using a cotton swab, the doctor cleans the surface of the cervix from secretions, then, using a special brush, material for research is taken, which is applied to a glass slide. This piece of glass will go to the laboratory, where it will be studied under a microscope.

How often should a cytological smear be taken for analysis?

The Association for Cervical Pathology and Colposcopy gives such recommendations in this regard.

All women should start undergoing a cytological examination 3 years after the onset of sexual activity, but no later than 21 years.

Women from 21 to 49 years old need to undergo a cytological examination every 3 years, and from 50 to 65 years old - once every 5 years. However, there is a category of immunocompromised women (HIV-infected, after an organ transplant, after chemotherapy, or constantly using steroids) who must undergo this study annually. Gynecologists also advise women over 30 with normal Pap smears to have a human papillomavirus DNA test at every three-year checkup.

Women aged 65 and older who have had three positive cytology tests in the last 10 years may no longer have cervical cancer screening. However, this does not apply to those who have previously been treated for cervical cancer, HIV carriers or immunocompromised women. They need to keep testing.

A special group is made up of women who have undergone an operation to remove the reproductive organs. After a total hysterectomy (removal of the uterus along with the cervix), cytological screening is no longer needed, unless this operation was performed as part of the treatment of cancer or precancer of the cervix. If the amputation touched only the uterus, without removing the cervix (supravaginal amputation), then cytological screening should be continued, adhering to the general principles of cervical cancer prevention.

How to prepare for research?

First of all, a cytological smear is not taken during menstruation and during inflammatory processes of an infectious nature.

In order not to lubricate the pictures, two days before the study, it is not recommended to douche, insert tampons, suppositories or creams into the vagina.

You should also refrain from sexual intercourse two days before visiting the gynecologist.

What the results say

As a rule, the results of the Pap test come to the doctor in 1-2 weeks. And, if atypical cells are found in them, this does not mean a sentence. The revealed deviation from the norm is only a call to be alert and undergo additional examinations. In this case, first of all, a colposcopy is prescribed. This is a procedure for examining the vulva, vagina and cervix using a special device - a colposcope, which helps to identify the presence of lesions of the epithelium of the cervix and determine their nature. And already on the basis of this study, the doctor decides whether a cervical biopsy is needed.

What is a Pap test and why should a woman do it regularly will help to understand this article.

What is a Pap test

How often should you take a Pap test?

Screening (taking a Pap test) is prescribed from the moment of the onset of sexual activity. Up to 30 years - this is a mono test, and after 30 years before it, an analysis for the human papillomavirus (HPV) of a highly oncogenic type is additionally prescribed. Until the age of 30, such an analysis is not necessary, since the human papillomavirus at this age occurs in every third woman who is sexually active. And often he himself leaves the body without causing an oncogenic effect. But after the age of 30, an HPV test is very important because, together with risk factors, it is the #1 cause of cervical cancer. Also effective against the human papillomavirus is the vaccination of girls who are not sexually active (aged 11-14 years).

Passing a Pap test once is not enough. Only if a woman conducts such screening regularly can reliable conclusions be drawn about her state of health. This is especially important if the Pap test shows the presence of pathology. In this case, it is easier for the doctor to prescribe the correct treatment regimen precisely in the presence of the results of previous screenings, since the dynamics of the disease are well traced. Therefore, such screening - the conclusion of the PAP test for the detection of precancerous and cancerous diseases of the cervix - is systematic and regular. Back in the 70s, in many European countries, the Pap test was introduced as a regular and mandatory analysis. The results of this decision led to the fact that the incidence of cervical cancer was reduced to 70%.

It is necessary to take such an analysis in the first phase of the menstrual cycle, before the onset of ovulation. It is also necessary to refrain from sexual activity 2 days before its delivery.

A few days after taking the test, bloody discharge, a feeling of discomfort (which can also be when taking a smear) and pulling pains in the lower abdomen may appear.

If the result of the PAP test is negative, this means that no abnormalities in the structure of cells were found, there are no epithelial formations = the woman is healthy. If the Pap test is positive, then each patient should be considered individually. Additional examinations and an appropriate treatment regimen are prescribed. This is due to the fact that there are different categories of changes in cells: mild, moderate and severe, cancer. A positive PAP test indicates that there are deviations from the norm, but these are far from always indications for surgery and serious interventions.

Acute inflammatory processes or chronic gynecological diseases can worsen the results of the PAP test. If they are detected, treatment is prescribed, and after that - a repeated PAP test.

What else is important to remember

The human papillomavirus, which causes cervical cancer, is transmitted sexually. Therefore, if a woman has poor tests, and is also regularly worried about diseases in gynecology, then a man should also be examined by an andrologist.

Pap test and pregnancy

The danger lies in the fact that the initial forms of cancer are asymptomatic, and it is almost impossible for a doctor to determine them visually. Therefore, a Pap test should be done regularly in order to timely detect changes in the cells of the cervix and prescribe effective treatment.

Take care of your health regularly and be happy!

Modern medicine has become a leader in the field, based on the diagnosis and treatment of rather complex diseases. Specialists have learned to recognize various pathologies that previously ended in death. If we talk about gynecology, then this area in science is not in last place. Thanks to a number of diagnostic studies, today it is possible to prevent the development of such a terrible disease as cervical cancer. With the advent pap test, it became possible to detect oncology 4 times more often in the fairer sex, thereby reducing the mortality threshold.

Many women do not understand how important it is to have regular gynecological examinations and not to ignore the cytological smear (Pap smear) in the diagnosis. Often girls are stopped by the fear of the unknown. But these are completely unfounded fears. In order to analyze in detail what the affected manipulation is, it is worth more clearly describing what it is.

This procedure is a screening study that is carried out for every woman over 21 years old during a visit to a gynecologist for the purpose of a preventive examination. To do this, the doctor takes a swab from the cervix and cervical canal. Samples of the obtained material are applied to a glass slide and sent to the laboratory for staining of the material, as well as further research.

The diagnostic procedure is named after its founder Georgios Papanikolaou (English Papanicolaou test, Pap test or Pap smear). Thanks to his work, laboratory assistants can examine any cells, but they use the technique more often in gynecology.

Why is a Pap smear performed?

A cytological examination is carried out in order to detect abnormalities in the structure of the cells of the cervix and vagina. In order to detect malignant tumors in time, you should not neglect the diagnostic procedure, if only because health should always come first. Do not forget that cancer can progress within a short time, and this can lead to its metastasis and inoperability of the tumor. That is why it is so important to give , which helps to diagnose any pathological changes in the structure of cells at an early stage of the disease, and also enables patients to start timely treatment.

Purposes and indications for laboratory testing

Goals are diagnostics of the reproductive system, and quality control of treatment results. . Any type of research is carried out for medical reasons. Often a smear for cytology is given by a woman in the following cases:

• during treatment or after it;
• when diagnosing infertility;
• during the use of hormonal contraception;
• with frequent change of sexual partners;
• with and detection of genital genital warts;
• during the period of frequent infectious diseases of the reproductive system;
• during a preventive examination.

Risk group

Women at risk should undergo a gynecological examination and take a cytological smear with a regularity of 1 time in six months. The risk group includes people:

• early onset of sexual activity;
• having multiple sexual partners;
• women with a history of viral and;
• women who have a history of cancer of the reproductive system;
• lovers of bad habits (smoking, alcoholism);
• with hereditary predisposition to cancer.

Top article: Urinalysis for STDs and latent infections

When is the best time to get tested?

The period recommended for screening starts on the fifth day of the menstrual cycle and ends 5 days before the expected date of the onset of menstruation. Do not forget that any physiological processes in the vagina during bleeding may indicate the presence of a disease. That is why situations arise when material is taken regardless of the recommended period, but this is done only as directed by a doctor.

Attention! Screening is not available for women who have had their uterus removed and have not had cervical cancer in the past 20 years.

Are there any contraindications for taking a smear?

This study has no contraindications. However, it is not carried out if patients have inflammation of the cervix, since the result of the analysis will be incorrect.

Table with recommendations for different age categories for a Pap smear

How to prepare for research?

There is no special preparation for the test for cytology. True, there are general recommendations that must be followed 48 hours before the procedure:

• should refrain from sexual relations with a partner;
• it is necessary to exclude the use (suppositories) and vaginal creams;
• it is not recommended to douche and take a bath;
• you need to abandon hygienic tampons;
• do not do other diagnostic tests.

How to carry out the procedure

Before starting a medical manipulation, a woman should undress (remove everything below the waist) and lie on the edge of the gynecological chair. Then the doctor inserts a dilator into the vagina and provides a good visual view of the cervix. In the presence of discharge from the uterus, the gynecologist cleans the cervix with a swab. The sampling of material for research is carried out from several sites. It:

• vaults of the vagina;
• outer surface of the neck;
• cervical canal.

The collected material is placed on a glass slide and fixed with alcohol, or a special test tube with an alcohol solution is used.

What to avoid after the study

After the medical manipulation, a woman is recommended to follow several recommendations in order to prevent the development of complications:

• bathing should be avoided for 5 days after screening;
• you need to refrain from sexual intercourse for up to 5 days;
• it is necessary to abandon vaginal suppositories, creams and douches.

Possible Complications

Complications after screening are rare, as the diagnostic procedure is minimally invasive and specialists use sterile instruments. However, it should be remembered that exceptions to the rules are possible, such as:

• discharge of a bloody nature, characterized by low intensity;
• infection.

Getting diagnostic results

Getting test results by hand may vary, depending on the health facility where the woman was screened. In public hospitals, the waiting time can be 1 to 2 weeks. In modern clinics and medical centers equipped with the latest technology, it is possible to pick up the results of a Pap smear the very next day. Having received the results in her hands, the woman should contact her gynecologist in order to find out the PAP test decoding. It is possible to independently read and understand what the screening results indicate, but there are fears that if the patient is misinterpreted, she will miss precious time.

What can screening results say?

Test results can be positive, negative, or false positive. A positive test result is when changes in the structure of cells (anomaly of the nucleus or cytoplasm) are detected. These changes are usually observed in II, III, IV and V stages of the disease. Stages of the disease and morphological changes in cells:

• I stage. It is characterized by the absence of changes in the cells, which indicates a healthy state of the reproductive system.
• II stage. It is distinguished by the presence of signs of an inflammatory process in a woman. In this case, it is necessary to conduct additional research methods for diagnosis.
• III stage. Anomalies are found in the morphology of the collected material, therefore, a repeated smear for cytology is performed, a biopsy is taken, followed by a histological examination of the material.
• IV stage. The presence of cancer cells is noted, therefore, in a strict order, a biopsy is performed with the histology of the material taken.
• V stage. A smear shows a large number of tumor cells, which indicates advanced cancer.

Pap smear can indicate not only the presence of oncological pathologies, but also allows you to identify infections such as:

• human papilloma virus;
• - sexual infection, which tends to be asymptomatic and difficult to diagnose with conventional;
• gonorrhea (clapper) - a sexually transmitted disease caused by infectious pathogens;
• - an infectious disease affecting the organs of the human genitourinary system;
• infectious yeast of the genus Candida , commonly referred to as .

The presence of these infections can interfere with the detection of cancers. Therefore, having eliminated these diseases, it is worth re-passing the Pap test.

A cytological examination of a smear is a procedure that is absolutely safe for women, so it can be performed during pregnancy too.

In order to prevent, timely detection of cervical cancer, screening should be carried out regularly. Previously, it was recommended to carry out such preventive measures at least once a year, but modern achievements allow an increase in this period. The components of the screening are a variety of tests, among which the Pap test is the most popular.

The modern cervical cancer screening program in Russia - every woman should know this!

Innovations in the aspect of testing for the detection of the ailment in question were published in the journal Obstetrics & Gynecology in November last year. The author of the article is the American College of Obstetricians and Gynecologists, which painted algorithm, principles of cervical cancer screening.

The age of the female representative directly affects the indications for screening:

1. They survived an operation to transplant internal organs, had other manipulations, which negatively affected the immune capabilities of the body.
2. In the prenatal period, they received a certain dose of diethylstilbestrol, a synthetic substitute for the female hormone, which was popular in the 70s.
3. Are HIV-infected.
4. In the anamnesis of which there is information about the treatment of moderate, severe forms of dysplasia, cancer.

• Between the ages of 30 and 65, a Pap test + HPV test is recommended every five years. If there is no opportunity to test for the detection of the human papillomavirus, you can get by with one Pap test, which is not welcome among doctors. Such a survey should be carried out every three years.
• After the age of 65, female representatives do not need to be screened. If before reaching this age there were dysplasia (moderate, severe degree), adenocarcinoma, the need for screening will be relevant for 20 years.
• After surgical treatment, during which all the reproductive organs were eliminated, there is no need to screen the cervix.

Vaccination against papillomavirus does not affect the frequency of screening.

The human papillomavirus is widely known among women, due to its frequent diagnosis in a particular patient, but often it does not provoke cancer.

Danger arises when HPV has become chronic . If there are cells in the female body that can degenerate into cancer cells, it takes years to establish invasive cancer.

Double testing every five years favors balancing between the timely elimination of low-frequency manifestations of cancer and relatively dangerous medical procedures(for example, taking a substance for study). In the innovations, it is fixed that screening, as a surgical procedure, is needed in the presence of highly oncogenic groups of the human papillomavirus.

Although the need for an annual Pap test has disappeared, but visits to the gynecologist should not be ignored . In addition to the ailment in question, there are many other diseases that need to be eliminated in a timely manner.

Pap test, like a cervical cancer test - results, transcript of the Pap test

The relevance of regular preventive measures in the aspect of the disease under consideration lies in the high chances of its elimination when detected in the early stages. Cervical cancer is a common disease among the female population aged 16 to 53 years. Thanks to regular developments that improve the screening system, timely detection of this disease is not a problem.

The disease in question arises against the background of epithelial transformations, which are precancerous in nature. Such changes in the tissue of the cervix are called dysplasia (CIN). Often there is a development of the disease in the zone of docking of flat and glandular matter. The first covers the outer component of the cervix, the second - the cervical opening.

If you do not take measures to eliminate dysplasia, the latter will go mild to moderate, moderate to severe. This phenomenon requires control by the oncogynecologist. Through a screening program, it is realistic to detect and eliminate these changes before the moment when cancer has arisen.

The effectiveness of screening is directly proportional to its regularity. One of the most productive components of this procedure is the PAP test. The latter involves preliminary taking from the patient sample of cellular substance on the surface of the cervix that is carried out during a gynecological examination.

For this procedure, the doctor uses a vaginal mirror, a glass slide, medical brushes, and a spatula. Using a medical brush, the extracted material is placed on the glass, after which it is delivered to the laboratory.

Thanks to the staining of cells in a variety of dyes, it is possible to trace the transformations that have occurred in the nuclei, cytoplasms of microcells. Initially, the nature of the changes is studied in the laboratory: malignant, infectious, progressive. Then the analysis of those phenomena which are available is carried out.

The test results have several variations:

1. negative- cells have standard parameters, there is no precancerous condition;
2. positive– there are errors in terms of the parameter of the tested cells. In this case, you should not panic: the indicated result is not a guarantee of the presence of cancer. There may be several options for an anomalous result. An algorithm of actions for a particular result exists:

• ASCUS. This concept denotes microcells that are non-standard for the matter of the cervix. They often occur against the background of inflammation in the specified part of the body. They can be eliminated by eliminating the inflammatory process. Patients with this result should have a new Pap test in six months. As an alternative option, an HPV test, colposcopy is suitable;
• ASC-H. One of the options for atypical transformations of cervical cells, which are characterized by a flat shape. Colposcopy + biopsy is required to confirm / exclude a large-scale damage to the microparticles of the cervix;
• LSIL. Here there are minor errors in the aspect of the structure of the epithelium of the cervix. Such defects arise against the background of the spread of HPV, which provoked mild dysplasia. In this case, female individuals should duplicate the Pap test (after 5-6 months), or undergo colposopia + biopsy;
• HSIL. This result means that moderate/severe dysplasia, carcinoma, is present. In rare cases, regression of these atypical phenomena may occur, but often such changes favor the formation of cancer. To study in more detail the nature of the lesions, a colposcopy with a biopsy is needed.

After undergoing a biopsy, depending on the results obtained, the doctor determines the further scheme of action:

1. The biopsy states the norm. This means that there are no errors in the structure of the cervix, the patient is prescribed a second Pap test in a year.
2. CIN I. Errors are present, but they are minor, often self-destruct without medical assistance. Female representatives are offered to duplicate the Pap test in six months / perform a colposcopy + biopsy.
3. CIN II/CIN III. Errors are pronounced, to eliminate them, treatment is needed. Medical manipulations in relation to such a deviation are aimed at removing atypical cells in order to prevent their transformation into cancer.