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The Pap test is known as
a screening test because it helps identify people who need further
evaluation. The Pap test can detect changes in the cells of the
cervix at an early stage. For most women, a Pap test done each year
starting at age 18, or sooner if they become sexually active, is the
best screening method for finding changes in the cervix.
We now have a new method
of analyzing pap smears called “Thin Prep.” A sample of cells from
the cervix is placed in a bottle of liquid and sent to a pathology
lab for analysis. If the Pap test results show abnormal cells called
Atypical Cells of Undetermined Significance (ASCUS), a screen for
high risk Human Papilloma Virus (HPV) will be performed. This virus
can cause pre-malignant changes of the cervix called dysplasia. If
the high risk HPV is detected, you may be advised to have further
tests to diagnose the problem.
Dysplasia is a type of
cervical disorder that occurs when there is a change in the cells on
the surface of the cervix. Abnormal cells replace normal,
non-cancerous cells. These changes are called dysplasia. Dysplasia
is found in women of all ages, but it is becoming more common in
young women and teenagers. Risk factors for dysplasia include
history of genital warts, more than one sexual partner, sexual
activity before the age of 20 and smoking. The range of dysplasia
includes mild, moderate, severe and carcinoma in situ (CIS).
ClS is not a true form
of cancer, but is the most likely to develop into cancer if not
treated.
Colposcopy is the next
test performed if a Pap test is abnormal. It is a way of looking at
the cervix through a special magnifying instrument called a
colposcope. It lets your doctor detect problems of the cervix that
cannot be seen with the eye alone. This procedure is performed in
our office.
For the colposcopy exam,
a speculum like the one used during a Pap test is placed in the
vagina. The cervix will be cleansed with a mild vinegar solution
that sometimes causes a slight burning sensation. A colposcope
magnifies the cervix and allows the doctor to examine the cervix
more closely. The colposcope itself does not touch you.
When abnormalities on
the surface of the cervix are seen by colposcopy, a biopsy will be
done to diagnose the problem. In this procedure, small pieces of
cervical tissue are removed for study. The lining of the cervix will
be scraped to identify abnormal cells that could be higher in the
canal beyond view. You may have some mild cramping or feel a
pinching sensation. Taking Motrin or Advil 400-600mg one hour
before the procedure will help with any cramping you may experience.
If you have a cervical
biopsy, a short period of healing time is necessary. You can expect
some light bleeding, which is normal. A solution called Monsel’s is
applied to the cervix after the colposcopy. It will cause a “coffee
ground” discharge, which is normal. You will be able to shower or
take a bath after the procedure. Sexual activity is fine, but you
may have some irregular spotting or bleeding afterwards. Bleeding
which is heavier than a menstrual period should be reported to the
office.
The results of your
biopsy will usually be available in 7 to 10 days. The nurse or
doctor will review your results with you and discuss any follow-up
treatment required.
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