What is a cervical cytology? | Medical tests

Examination of the cells of the cervix in order to detect the existence of a possible cancer as soon as possible.

Cervical cytology

Cervical cytology is a diagnostic test in which cells of the cervix are examined. The neck of the uterus, also known as cervical, is bottom and narrower than the uterus and is located at the end of the vagina. The cells are obtained by inserting a brush and a small spatula in the vagina that is a soft scraping at the neck of the uterus. The sample extends in a Crystal called porta or gets into a preservative fluid to later watch it under the microscope.
Cytology cervical cervical or also called commonly Pap smear, vaginal smear or Pap test, in honor of a Greek doctor who developed this technique in the first half of the 20th century.
The objective of this test is to detect the existence of a cervical cancer of uterus, or precancerous lesions in the same, as soon as possible in order to treat it as early as possible. In almost all cases, cervical cancer is associated with an infection by a virus called the human papilloma virus (HPV), acquired sexually. This virus causes changes in the morphology and structures of the cells of the cervix which makes that they can transform into malignant cells. The scraping is done during the test includes these cells, which may have pre-malignant changes indicative of that are evolving into cancer, or may already be cancer cells.
HPV in samples taken from the cervix can also be detected. Therefore some of the samples that are taken from the cervix is sent to the lab to investigate the presence of this virus. However, still not been determined clearly when the detection of HPV and its utility test should be performed.

When should I do a cervical cytology?

Recommendations to make a cervical cytology change across countries and even change between medical institutions within the same country. In general it is recommended to start making them three years of onset of sexual relations, starting from age 21-25 depending on the countries, and repeat them at least every three years. Most common controls may be recommended if the previous results are not entirely normal or the woman has some factors that can facilitate the appearance of tumors, such as infection with HIV or other immune disorders.
When it has been five years of the last PAP, some organizations recommend annual Pap during the first two years and then every three years. Pregnant women and women who are vaccinated for HPV should also perform their cervical cytology with normality.
In the event that you perform a cytology together with a test for the detection of HPV, and both tests are negative, it is recommended to repeat cytology after five years.

When is it not necessary to do a Pap smear?

Cytology in very young women, age 21-25, are not recommended because before that age of cervical cancer is extremely rare. Moreover, in young women and adolescents is frequent that there are alterations in the cytology disappear spontaneously. Nor has been shown to be effective screening with cytology in young women. In general is not recommended to perform the test for the detection of HPV before age 30.
There to do a PAP to women who have not had sexual intercourse. This is because that cervical cancer is practically always associated infection by the human papillomavirus which is acquired through sexual. If you have not had sex, there was no infection by this virus or risk of cancer of the cervix. Women older than 65 - 70, could stop to Pap smears if they have three normal Pap smears in the last 10 years, and the last has been done in the last five years, but it depends on if they remain sexually active.
Finally, there is also no that do Pap smears to women who have undergone a total hysterectomy for a benign disease, i.e. who is has removed completely the uterus fibroids or other pathology not tumor. If it has already removed this body, it is not possible that a cancer appears in the cervix. Pap smears are continuing if there has been a history of precancerous lesions or if the uterus has removed because of cancer of the cervix.

Preparation for a cervical cytology

These are the issues that you must consider when ready for a cervical cytology:
Duration: the test is performed in a few minutes.
Entry: the test is done on an outpatient basis.
Is necessary to be accompanied?: don't have to be accompanied by although it might help if it makes you feel more relaxed.
Drugs: is not necessary to take any prior medication. You can take your usual medication.
Food: don't have to go on fasting.
Clothing: you can wear any clothes you want, but it is important that you can undress easily from waist down.
Documents: in general any document does not lack.
Contraindications: You don't want to do the cytology if she is menstruating because the rule may be difficult interpretation of the sample. Pap smears don't occur in very young women or who have never had sexual relations.
Pregnancy and lactation: not contraindicate the realization of the test although it is important to tell your doctor the possibility of that is pregnant.

Other considerations on cervical cytology

It is important to avoid sexual intercourse, DOUCHING and using tampons or vaginal creams 24-48 hours before the test.
You can be more comfortable if you empty the bladder and the bowel prior to testing.
If you are allergic to latex should warn their doctor explore it with gloves made of other materials like vinyl.

How is a cervical cytology?

Cervical cytology is carried out in a health centre and is carried out by the doctor, nurse or any other trained health professional. Prior to performing the test will inform you of the procedure, which lasts just a few minutes and the possible inconvenience may cause, since it just has risks.
The female tomb is face-up on a special table that facilitates the exploration of the genital area. A Speculum is inserted into the vagina, which is an instrument with two valves that are separated and allow open the vaginal cavity and observe in the background of the cervix. With a small spatula and brush is a soft scraping on the inside and on the outside of the neck of uterus. Take several samples that extend into small glass that looks under a microscope, or enters a preservative fluid for further consideration.
It is very rare that this test may cause complications. There may be a minimum bleeding that causes a vaginal spotting small, but that is considered normal. The risk of infection is minimal. It is not a painful test, although the inclusion of the Speculum can be uncomfortable when the woman is not relaxed.

Results of a cervical cytology

The PAP cytology results are usually available within two weeks. It is advisable to go to pick up the result and not assume everything is normal because the results you are not delivered in a few weeks. The doctor will give you the results and will indicate the need for any treatment or other complementary explorations.
The results of a cervical cytology is often report follows:
Normal cytology, in which there is no evidence of malignant cells.
Inadequate cytology, which not is has been able to study properly sample for what they should repeat it.
ASCUS, an acronym which comes from the English (atypical squamous cells of undetermined significance) and which translates as 'atypia of undetermined significance'. This result is quite common and means that the cells are not quite normal, but that changes that do not have a meaning clear. In many cases, these changes disappear spontaneously and require no treatment. In any case this diagnosis requires tighter control and to worsen abnormal changes may require treatment.
Low grade or SIL intraepithelial lesion (squamous intraepithelial lesions) of low grade. This means that cells have been found with abnormal changes caused by HPV. Called intraepithelial because they are cells that are within the layer that surrounds the neck of the uterus and epithelium. Like the ASCUS, low-grade SIL may disappear spontaneously and require no treatment, but requires more frequent controls if they develop into malignant cells.
High intraepithelial lesion grade or SIL of high degree. They are cells with large abnormalities and a high probability of evolving into cancer if not treated. Sometimes high grade SIL classified into several categories according to the degree of abnormality of the cells. These changes do not tend to disappear spontaneously and often require a more comprehensive study and treatment.
Squamous cell carcinoma. It means that they have been detected cancerous cells on cytology. This finding is very uncommon in people who have been properly made its revisions.

Limitations or errors in the results of cervical cytology

Although cervical cytology is one of the best tests of screening there in medicine, and has managed to decrease the incidence of cervical cancer by 50%, admittedly has some limitations. Sometimes, cytology does not detect cancerous cells that do exist, what is called a false negative, or conversely, can diagnose that there are abnormal cells when there is cancer, what we call false positive.
These errors can occur because samples are taken in areas where it is not the tumor or errors in the processing or analysis of the sample. That is why it is important to go to centers with good quality controls and get tested regularly.
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