Guidelines for cervical cancer screening programme be aware, fight cancer guidelines for. Papanicolaou stain also papanicolaous stain and pap stain is a multichromatic staining histological technique developed by george papanikolaou, the father of cytopathology. 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. Cytology pap smeargynecological specimen principle. Papanicolaou stain an overview sciencedirect topics. This method is used to differentiate cells in the smear preparation of various gynecological specimens pap smears, materials containing exfoliative cells and material from fine needle aspiration. 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. A pap test, also called a pap smear, is an exam a doctor uses to test for cervical cancer in women. Removal after consecutive negative pap smears consecutive negative pap smears and negative hrhpv results 3 years from the last identified criterion for high risk status. Hpv tests detect hpv infections that can cause cervical cell abnormalities. Gynaecological cytology pap smears the cervical pap smear is a long established screening test for cervical carcinoma. Cytopathologic tests are sometimes called smear tests because the samples may be smeared across. To detect epithelial cell abnormalities in unhealthy cervix using the 2001bethesda system of reporting for cervical cytology and to confirm histopathologicaly the findings of pap smear.
Do not let the specimens dry at any stage of the staining procedure. The pap smear is a screening test and should not be used as the sole means of detecting cervical cancer. Cervical smears from women with keratinizing carcinomas contain. Pattern of cervical smear cytology in rural medical college. Histopathology and cytopathology of the uterine cervix digital atlas. It can also reveal changes in your cervical cells that may turn into cancer later. A comparison of 3 ways of conventional pap smear, liquid. It is very successful for detecting squamous lesions and. Application of bethesda system for cervical cytology in.
If recommended, women should be referred promptly for colposcopy and a copy of the cytology result must. The absence of transformation zone is not a reason to repeat a pap test earlier than the. Specimens may be submitted as conventional smears, although the preferred method is the thinprep pap test. Cervical cytology became the standard screening test for cervical cancer and premalignant cervical lesions with the introduction of the papanicolaou pap smear in 1941. Many women feel anxious or worried when they are told their pap test result is not completely normal. Pap smears were taken from 160 patients with gynaecologic complaints with ayres spatula and endocervical cytobrush and slides prepared. Detecting cervical cancer early with a pap smear gives you a greater chance at a cure. Chlamydia testing using floq and uriswabs is also discussed.
The awareness of pap smear test which was measured by weighting different questions in the questionnaire by experts, prove that the women aged above 39, have an average level of. Not all problems need treatment, and those that do. Since the publication of the 2006 consensus guidelines, new cervical cancer screening guidelines have been published and new information has. Get detailed information about the evidence behind, and the potential benefits and harms of cervical cancer screening in this summary for clinicians. Papanicolaou smear cytology is widely accepted as a valuable diagnostic tool in the detection of cervical cancer and has also been described to be useful in the diagnosis of external ocular tumors. Edited by frappart l, fontaniere b, lucas e, sankaranarayanan r. Cervical cytology became the standard screening test for cervical cancer and premalignant cervical lesions with the introduction of the papanicolaou pap smear. Cervical cytology sensitivity and specificity overall sensitivity. 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. Essentials of gynecologic cytology pathology university of british. 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. Management algorithms for abnormal cervical cytology and. Pap staining is used to differentiate cells in smear preparations of various bodily secretions.
It identifies premalignant changes and allows selection of women with atrisk findings for more intense clinical examination, treatment and followup. Pamlpshmc cytology uses the bethesda 2001 reporting system for all gyn samples. Pap smears can be abnormal if the cervix is inflamed or irritated. Therefore, women should continue to have cervical cancer screening by pap smear regardless of their vaccination status. Endometrial cytology has not been widely used because of overlapping cells and blood contamination. Ppap smear reportingap smear reporting the pap smear reporting classification has evolved and been refined over time. 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. Screening test for cervical carcinoma and precursor lesions exfoliative cytology pioneered by george papanicolaou in 1920s more than 60.
Pap smear and breast cytology pathology university of british. The bethesda system and guidelines for the management of. No cervical cancer screening recommended 65 years old if they have had prior adequate screening negative cytology alone or negative cytology and hpv as last pap smear even if a women has a new sexual partner after age 65, she does not need to be rescreened if above criteria are met. Several recent metaanalyses have reported quite low pap smear sensitivities in the range of 50% but as low as 20%. Most cases that have reported the cytological features of uterine carcinosarcomas have been described on cervicovaginal smears. The pap test or pap smear looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Pap smears, cytology and cchc lab work and follow up. At the end of the test or after every question if you want you will have the possibilty to view the correct answers, and in some but not. It may be followed by other tests like a pap for triage. The detection of hpv in pap smears rests predominantly on the identification of cells known as koilocytes, derived from the greek word koilos meaning hollow or cavity. Cervical cancer screening guidelines for averagerisk women. The study was undertaken to evaluate liquid based cytology pap spin and to compare the sensitivity of pap spin with conventional pap smear. Papanicolaou stain pap stain protocol ihc world, llc.
The following outline is a brief reference to the information thatwill be contained in the cytology report. Cells are scrapped or brushed by a qualified physician, physicians assistant, nurse, or. Learn how pap and hpv tests are done, how often testing should be done, and how are hpv test results are reported. Guidelines for cervical cancer screening programme. Pap tests detect abnormal cervical cells, including precancerous cervical lesions, as well as early cervical cancers. Cervical cytology by papanicolaou pap smears is an effective means of screening for cervical premalignant and malignant conditions. If a womans cytology is normal, she should be screened every three years. This test specifically identifies hpv 16 and hpv 18, while concurrently detecting 12 other types of high risk hpvs. Alcohols used for wiping the skin may cause hemolysis and artifacts. Dysplasia means the cells on the pap smear look abnormal. A comparison of 3 ways of conventional pap smear, liquidbased cytology and colposcopy vs cervical biopsy for early diagnosis of premalignant lesions or cervical cancer in women with abnormal conventional pap test. Most information and illustrations in this book are extracted from the authors. It is important to remember that almost all abnormal pap test results are not due to cancer.
The specific cytological abnormality that led to the colposcopic examination, this is usually the most recent pap smear prior to the actual colposcopic examination. A pap smear involves collecting cells from your cervix the lower, narrow end of your uterus thats at the top of your vagina. This technique was developed by george papanicolaou, the father of cytopathology. Management of abnormal pap smear clinical practice. Pap test results pap tests, pap smears, hpv, cervical cancer. The current reporting system is the bethesda system, which was introduced in 19886 and later updated again in 1999 table 1. Siobhan bourke discusses and demonstrates correct technique for taking cervical samples. Conventional pap smear and liquid based cytology for. For example, a common application of cytopathology is the pap smear, a screening tool used to detect precancerous cervical lesions that may lead to cervical cancer. The aim of this study is to evaluate the abnormal cytological entities. Liquidbased, thinlayer preparation of cervical cytology specimens was a subsequent modification in technique. The cervix may also be going through some changes called dysplasia.
Gynecologic cytology laboratory practice and methodology. 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. Pap smears are not perfect for a high grade lesion, the sensitivity of a single pap smear is only 6080% estimated false negative rate is 3050%. It is this area that the sample is taken from for the pap smear. Thinlayer cytology is a new technology for processing cytological samples.
Screening with conventional pap testing should occur every year. Gynecologic usually refers to pap test specimens, i. A pap smear, also called a pap test, is a procedure to test for cervical cancer in women. Comparison of conventional pap smear and liquidbased. The human papillomavirus hpv test looks for the virus that can cause cell changes. Screening test for cervical carcinoma and precursor lesions. A liquidbased thinprep papanicolaou pap smear was performed. Women presenting with unhealthy cervix needs to be evaluated with papanicolaou pap smear for epithelial abnormalities. The papanicolaou smear or the pap smear has been widely available since its first introduction into singapore in 1964. There have been a large number of studies which have proved the. This characteristic background is usually less prominent in liquidbased cytology specimens.
Detection of abnormal cervical cytology in papanicolaou smears. Gynecologic cytopathology is a subset of cytopathology. Sampling of the cervical transformation zone, which is most vulnerable to this infection, is an integral part of the pap smear 15, 16,106108. 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. Ontario cervical screening guidelines summary cancer care.
The society for lower genital tract disorders since 1964. Staining methods histology and cytology 152 notes sources of errors irregular distribution of the blood smear on a glass slide may result in an erroneous cell counts. An introduction to cytopathology is in the cytopathology article cervical cytology redirects to this article. Primary hrhpv testing is defined as a standalone test for cervical cancer screening without concomitant cytology testing.
Pdf cytopathological pattern of cervical pap smear according to. Smear tbs 2001 separates unsatisfactory for technical reasons from those processed but unsatisfactory typical rates of unsatisfactory smears are reported as 0. Pdf cervical carcinoma is an important womens health problem worldwide. Pattern of cervical smear cytology in rural medical college shrivastava m, shrivastava o p, jaiswal s s abstract the present study was undertaken with the aim to evaluate the abnormal cytological entities detected by cervical pap smears among patients reporting to outdoor department of.