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An opportunity to improve screening rates. Early detection is the key to preventing cervical cancer deaths. Yet, data spanning June 2016 to May 2019 published in the American Journal of Preventive ...
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]
Cytologic tests include conventional Pap smear and liquid based cytology. Visual Inspection tests involve application of a solution to enhance identification of abnormal areas and can utilize the naked eye or a colposcope/magnifying camera. [3] Medical organizations of different countries have unique guidelines and screening recommendations.
The Pap test can be used as a screening test, but produces a false negative in up to 50% of cases of cervical cancer. [56] [57] Other concerns is the cost of doing Pap tests, which make them unaffordable in many areas of the world. [58] Confirmation of the diagnosis of cervical cancer or precancer requires a biopsy of the cervix.
Because of the link between HPV and cervical cancer, the ACS currently recommends early detection of cervical cancer in average-risk asymptomatic adults primarily with cervical cytology by Pap smear, regardless of HPV vaccination status. Women aged 30–65 should preferably be tested every 5 years with both the HPV test and the Pap test.
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 Pap test is still widely used as a means of early cancer detection and is estimated to have reduced fatalities caused by cancer of the reproductive systems in women by half. [10] By some accounts, the pap test is considered the most significant advance in the control of cancer in the 20th century. [11]
A Pap test may be performed according to guidelines, and testing for Neisseria gonorrhea and Chlamydia trachomatis may be performed as indicated. [24] A bimanual examination during early pregnancy will reveal that the uterus is enlarged, softened and globular; the external os may be dilated, but the internal os is typically closed. [24]