Cervical Dysplasia (cont.)
Are there symptoms or signs of cervical dysplasia?
Typically, cervical dysplasia does not produce any signs
or symptoms. So regular screening is important for early diagnosis and treatment.
How is cervical dysplasia diagnosed?
Screening for cervical dysplasia
Cervical dysplasia and cervical cancer generally only
develop over a period of years, so regular screening is essential to detect and treat early
precancerous changes and prevent cervical cancer. Traditionally, the
Papanicolaou test (Pap test or Pap smear) has been the screening method of choice. To perform the
Pap smear, the health care practitioner removes a swab or brush sample of cells
from the outside of the cervix during a pelvic examination
using a speculum in the vagina for visualization. The cells are smeared onto a
glass slide, stained, and observed under the microscope for any evidence of
dysplasia or cancer.
Newer, liquid-based systems to screen samples of cervical cells are also
available and are effective screening tools for detection of dysplasia. The
samples for this test are removed as for the conventional Pap smear, but the
sample is collected in a vial of liquid that is later used to prepare a
microscope slide for examination as with the Pap smear.
Further testing
For women whose initial screening result is unclear or abnormal, other
diagnostic tests are used:
- Colposcopy is a gynecological procedure that illuminates and magnifies the
vulva, vaginal walls, and uterine cervix in order to detect and examine
abnormalities of these structures. A
colposcope is a microscope that resembles a
pair of binoculars. The instrument has a range of magnification lenses. It also
has color filters that allow the physician to detect tiny abnormal blood vessels
on the cervix. The colposcope is used to examine the vaginal walls and cervix
through the vaginal opening. Colposcopy is a safe procedure with no
complications other than mild vaginal spotting of blood.
- Biopsies are tissue samples obtained for examination under the microscope A
biopsy may be taken of suspicious areas seen during colposcopy.
- HPV testing to detect whether or not HPV infection with a "high-risk" HPV
type is present may be recommended for some women. This may be particularly
useful if the results from regular screening tests are ambiguous, such as
results suggesting atypical
squamous cells of uncertain significance or ASC-US
(see below). Because of the number of women infected with HPV in general and
because the infection can be temporary and short-lived, regular screening of all
women for HPV infection is not thought to be useful and is not routinely performed
in the U.S.
Next: How is cervical dysplasia classified? »
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