Pathology of Cervix, Vagina, and Vulva 3

Question 1

What is the pap test?

Answer 1

• Exfoliation of cells from the surface of the cervix with a brush or broom
  
  • Actual tissue usually not obtained
• If dysplasia is identified, can be graded and managed accordingly
• Most valuable screening test for reducing cancer mortality and has led to a dramatic delcine in the past century

Question 2

What are some downsides of the pap test?

Answer 2

• Requiers a confirmatory test
  
  • colposcopy and bx
• Not 100% sensitive
  
  • now combined with high risk HPV testing

Question 3

What courses of action are taken based on pap test results?

Answer 3

• Mild dysplasia - observation since most regress
• Moderate to severe dysplasia - excision with subsequent procedure
• Invasive carcinoma - can be detected but the goal of the pap test is to identify and prevent early dysplasia
• Increasingly used with assays that detect HPV in the cells to increase sensitivity