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The cause of CIN is chronic infection of the cervix with HPV, especially infection with high-risk HPV types 16 or 18. It is thought that the high-risk HPV infections have the ability to inactivate tumor suppressor genes such as the p53 gene and the RB gene, thus allowing the infected cells to grow unchecked and accumulate successive mutations, eventually leading to cancer.
A precancerous condition is a condition, tumor or lesion involving abnormal cells which are associated with an increased risk of developing into cancer. [1] [2] [3] Clinically, precancerous conditions encompass a variety of abnormal tissues with an increased risk of developing into cancer.
The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), [1] cervical smear (BE), cervical screening (BE), [2] or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix (opening of the uterus or womb) or, more rarely, anus (in both men and women). [3]
Cervical cancer screening is a medical screening test designed to identify risk of cervical cancer. Cervical screening may involve looking for viral DNA, and/or to identify abnormal, potentially precancerous cells within the cervix as well as cells that have progressed to early stages of cervical cancer .
Cervical cancer typically develops from precancerous changes called cervical intraepithelial neoplasia over 10 to 20 years. [3] About 90% of cervical cancer cases are squamous cell carcinomas, 10% are adenocarcinoma, and a small number are other types. [4] Diagnosis is typically by cervical screening followed by a biopsy. [2]
It functions as a lighted binocular or monocular microscope to magnify the view of the cervix, vagina, and vulvar surface. [12] [13] Low magnification (2× to 6×) may be used to obtain a general impression of the surface architecture. 8× to 25× magnification are utilized to evaluate the vagina and cervix.
The most common investigation in this field is the Pap test, which is used to screen for potentially precancerous lesions of the cervix. Cytology can also be used to investigate disorders of the ovaries, uterus, vagina and vulva. Gynaecologic cytology makes frequent use of the Bethesda system in order to grade the results of HPV testing. [2]
The cells on the 'outside' of the cervix are typically squamous epithelial cells. Where the two cells meet is called the transformation zone, also known as the stratified squamous epithelium . Cervical ectropion can be grossly indistinguishable from early cervical cancer and must be evaluated by a physician to determine risks and prognosis.