Smear Test Flashcards
What does an abnormal smear test mean?
Vast majority of women do not have cancer with an abnormal smear but instead CIN - when these changes are found it is really easy to remove them completely
You may be asked to attend a colposcopy clinic
What does CIN mean?
CIN is a precancerous change of the squamous cells for the cervix
Different grades of CIN with CIN 1 being minor changes and CIN 3 severe changes
Most cases of CIN 1 will go back to normal with no treatment
There is a rare abnormality called cGIN which is cervical glandular intraepithelial neoplasia which is the same but involving cells of the inner glandular cells of cervix
Why can a smear be inadequate?
For one reason or another the process required to produce a sample for the cytologise who reads the smear is unsatisfactory
This could be from difficult obtaining enough cells for lab to read or too much blood on the smear
If post-menopausal can try vaginal oestrogen cream
You will be asked to attend a further smear in 3 months
Describe a smear result?
Mild mod or severe dyskaryosis which equals CIN 1, 2 or 3
Borderline change requires a colposcopy app only is it remains after 2-3 smears taken at 6 monthly intervals
How many women will have an abnormal smear?
1 in 20 women
1 in 2000 will have cervical cancer
Does the pill increase risk of cervical cancer?
Very slight increase
Recent study showed this is mostly in women with HPV
What is colposcopy?
More detailed examination of cervix
Use magnifying binoculars to see cervix at high magnification
Do you need to remove your coil before colposcopy clinic?
No
Most colposcopists will perform a colposcopy and if a loop excision is needed, will loop around the coil and threads
What dyes are applied to the cervix at colposcopy?
Acetic acid; abnormal areas such as CIN will turn white
Schiller’s Iodine test; precancerous lesions will not stain bron
How is a diagnosis made at colposcopy?
How white the tissue goes after acetic acid and how quickly it turns
How smooth or irregular the surface is
Different patterns of blood vessels (mosaic and punctation)
What is the aftercare after a cervical biopsy?
May have blood stained discharge or light bleeding for a few days
Avoid sexual intercourse and tampons for a few days
How can CIN be treated?
Large Loop Excision of Transformation Zone LLETZ
Ablation
What can you expect after treatment for CIN?
Period-like cramps - if so; paracetamol or ibuprofen
LLETZ; blood stained discharge; will settle in 2 weeks but may last for 4-6 weeks
Avoid sexual intercourse and tampons for 4 weeks
Avoid bathing or swimming for 2-4 weeks
In terms of future pregnancies; are there any problems with loop excision?
Higher risk of preterm delivery
If this is an issue; can have cervical stitch inserted when pregnant
Is any follow up needed after LLETZ/ biopsy/ ablation?
Smear check in 6 months to ensure treatment has been effective
Check than HPV has resolved
If all normal, you will have annual smears for a couple of years then back to 3 yearly smears
