Cervical Dysplasia - Diagnosis

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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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See what others are saying

Comment from: magdew, 45-54 Female (Patient) Published: March 05

I was diagnosed with my first abnormal Pap in 2004 after I gave birth to my last son. I was told I did not have HPV (human papilloma virus) at that time and they did follow ups for 6 months. I was given the all clear. I go every year faithfully to have my yearly exam. Everything was normal up until last year at the age of 44 I had an abnormal Pap. I went for the biopsy and was told that everything looked fine. I was told at that time that I had HPV. This year my Pap came back abnormal again and this time the biopsy showed high density cervical dysplasia and I am scheduled for a LEEP (loop electrosurgical excision procedure) in two weeks. I am scared like other people on here, and they are telling me not to worry too much but this is a very scary thing.

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Comment from: Lynnie, Female (Patient) Published: February 17

I always hated going for a Pap. I always have used any excuse to justify not going. In 2006/2007 it was so long ago I don't remember quite when, I had some abnormal cells and had to go for a colposcopy. I found the whole experience irritating to say the least because the doctor seemed to talk down to me telling me they weren't really abnormal cells because if they were they would turn a differently color when he used the vinegar solution, which they did and again when he used the iodine solution. Then he told me he had to do a biopsy and when I started to shake said no and changed his mind. I got mad and walked out thinking that if he wasn't going to take it seriously neither was I and I never went back. Until October of 2015, when they screwed up my results with someone else's and I had to go again in January 2016. I have highly abnormal cells with severe dysplasia. I am again scheduled with a colposcopy and I am terrified, because of my own stupidity I have been unmonitored for over 10 years and I am unsure of what to expect. Over the last 10 years my periods have been a nightmare, I bleed so heavily and I can't wear tampons because they either cause a lot of pain and I leak through the heaviest one within an hour of putting it in. I take anywhere from 4 to 5 Tylenol extra strength just to be able to go to work and function and walk. Now I have left this so long who knows what is in store for me. I am really nervous and I just can't stop kicking myself.

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