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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]
The Bethesda system (TBS), officially called The Bethesda System for Reporting Cervical Cytology, is a system for reporting cervical or vaginal cytologic diagnoses, [1] used for reporting Pap smear results. It was introduced in 1988 [2] and revised in 1991, [3] 2001, [1] [4] [5] and 2014. [6]
The United States Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services". [1]
Normal cervical cells in a Pap smear. In the conventional Pap smear, the collected cells are smeared on a microscope slide, and a fixative is applied. The slide is evaluated in a pathology lab to identify cellular abnormalities. Accuracy of conventional cytology report: [10] sensitivity: 55% to 88%; specificity: 71% to 94%
Cervical cancer screening recommendations have not changed for females who receive the HPV vaccine. It remains a recommendation that women continue cervical screening, such as Pap smear testing, even after receiving the vaccine, since it does not prevent all types of cervical cancer. [160] [162] Both men and women are carriers of HPV. [163]
The Clinical Laboratory Improvement Act of 1988 (CLIA 88) was passed in the USA subsequent to the publication of an article in November 1987 in The Wall Street Journal entitled "Lax Laboratories: The Pap Test Misses Much Cervical Cancer Through Labs Errors", which alerted the public to the fact that a pap smear may be falsely negative.
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Depending on patient's age or Pap smear result, HPV testing may also be performed. Sexually transmitted infection screening - Depending on age and risk factors, clinicians may recommend gonorrhea or chlamydia testing at the time of the well-woman exam. This sample can be collected via a swab of the cervix or vagina.