This is what you must know about cytology
Is the so-called "two" in cytology is a cause for concern? How often do you need to have a cytology? Do you need to prepare for it? Check what the specialist, Prof. Ewa Barcz, head of the Department of Gynecology and Obstetrics at the Międzyleski Specialist Hospital in Warsaw, says about it.
See the video: "What can Pap smear detect?"
1. Cytology results
Let's start with the fact that the once popular Papanicolaou Papanicolaou Pap test result, according to which you were given "two", "three" or "four" (second, third or fourth group), is now the history of medicine.
Currently, the description of the cytological result according to the Bethesda system is valid.
- The test result is now presented by the cytologist in a descriptive form - he writes about what the epithelial cells look like, whether they have pathological features, if so, what type, describes the infectious factors, whether bacteria or fungi appear in the smear, describes the elements and features of regeneration , post-radiation changes - in short, it describes everything that notices there - says gynecologist prof. Ewa Barcz, head of the Gynecology and Obstetrics Department at the Międzyleski Specialist Hospital in Warsaw.
The old nomenclature is therefore used only out of habit. In practice, they are still encountered, but rather as an annotation.
- We get descriptions according to the scale of the Bethesda system and at the end there is a phrase, for example: "what corresponds to group 2 according to Papanicolaou." In the environment of specialists, it does not need to be explained. Sometimes patients, used to such nomenclature, ask, using the old nomenclature: does it mean that I have two? ", but this nomenclature is no longer officially used - says the specialist.
The 4 most common questions about the Pap smear test. The gynecologist answers [5 photos]
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Is the so-called "two" - no matter what we call them - is a cause for concern?
The specialist replies that from the point of view of screening tests for cancer, "two" is normal cytology - in the Bethesda system it means that there were no epithelial abnormalities, i.e. cancer, or dysplasia, i.e. a precancerous state.
- This is a correct result from the point of view of oncological prophylaxis. Moreover, it does not necessarily need to be corrected. These can be normal inflammatory epithelial cells, which do not always require treatment. In the cytological sense, inflammatory reaction is not always an active infection. Naturally, if a patient has symptoms or features of infection, treatment will be necessary, but if there are no other signs of infection, this is physiological, explains Prof. Ewa Barcz.
2. What is Pap smear?
The Pap smear test is an effective, painless and safe examination of cells from the cervix by inserting a speculum into the vagina, collecting the cells with a special brush from the disc and the cervical canal, and then applying a smear to the cytological slide. The collected material is sent for microscopic evaluation.
The cytologist assesses the correctness of epithelial cells. Cytology allows to detect abnormalities suggesting a precancerous or neoplastic condition of the cervix when there are no symptoms.
It allows you to assess whether a woman is at risk of developing cervical cancer. An abnormal result is not the same as a cancer diagnosis!
The third group in the old typology, or "three," which was once synonymous with suspicion of dysplasia, or suspected precancerous condition or cancer, is today described as abnormalities in epithelial cells corresponding to low, medium or high degree dysplasia.
- Dysplasia is a pathological diagnosis that describes changes in epithelial cells that may affect different layers of the epithelium. These are not cancer cells yet, but if left untreated, they can undergo neoplastic transformation - says the gynecologist.
3. When is colposcopy necessary?
If the pathology of epithelial cells is suspected, colposcopy is performed.
- It is an examination of the cervix with magnification - a colposcope is a type of microscope with magnification of more than 20x, which shows exactly the affected areas, and thus allows you to take, for example, samples for histopathological examination, i.e. examinations that ultimately decide the diagnosis: dysplasia, its absence , or already cancer - explains the specialist.
If we are dealing with an abnormal cytology, colposcopy or abnormal histopathological result, it is worth performing additional tests for HPV.
- In the case of HPV, there are highly oncogenic viruses - carrying the risk of high-grade dysplasia or neoplastic transformation, and low-oncogenic viruses, where neoplastic transformation is very unlikely. The procedure is determined depending on the result: one can propose a wait-and-see procedure - e.g. observation or inclination towards more invasive actions, e.g. conization of the cervix, i.e. excision of a tissue cone from the vaginal part of the cervix, which allows to eliminate precancerous changes - says Prof. Ewa Barcz.
4. How often do you have a Pap smear?
Cytology should be performed from the moment of sexual intercourse, but not later than in the age of 21. Initially, it should be performed every year, and in the case of two consecutive correct results - once every 3 years.
5. How to prepare for a Pap smear?
- You should not come to the examination during menstrual bleeding,
- It is best to report the smear test no earlier than 4 days after the last day of menstruation and no later than 4 days before the start of menstruation,
- No vaginal medications should be used at least 4 days before the smear collection.
- At least 1 day should elapse since the last gynecological / transvaginal ultrasound examination.
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