Cervical Dysplasia - Diagnosis

Please discuss the tests and exams that led to a diagnosis of cervical dysplasia.

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How is cervical dysplasia diagnosed?

Screening for cervical dysplasia

Cervical dysplasia and cervical cancer generally 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 abnormal cells.

Newer, liquid-based systems to screen samples of cervical cells are also available and are effective screening tools for detection of abnormal cells. The samples for this test are obtained the same way as for the conventional Pap smear, but the sample is placed 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 surface abnormalities of the cervix, vagina and vulva.
  • A Biopsy is a tissue sample obtained for examination under the microscope. A biopsy is taken from suspicious surface areas seen during colposcopy. A diagnosis can only be made from a tissue biopsy.
  • HPV testing to detect a "high-risk" type is done if a Pap smear is abnormal or may be recommended for some women. Due to 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.
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