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8032
80199
2002 April ;287(16):2114-9
Cervical Papanicolaou Smear, Screening Without Physician
Interpretation
Clinical Information: Squamous cell carcinoma of the cervix is believed to develop in progressive
stages from normal through pre-cancerous (dysplastic, intraepithelial neoplastic, stages II in situ
carcinoma, and eventually invasive carcinoma). This sequence is felt to develop over a matter of years in
most patients. The etiology of cervical carcinoma is unknown but the disease is believed to be related to
sexual activity and possibly sexually transmitted viral infections such as human papilloma virus. Most
cervical carcinomas and precancerous conditions occur in the transformation zone (squamo-columnar
junction), therefore, this area needs to be sampled if optimum results are to be obtained.
Useful For: Cervical carcinoma and a number of infectious conditions of the female genital tract such
as herpes, Candidiasis, human papillomavirus infection, trichomonas, etc.
Interpretation: The report is an estimate of the nature of the abnormality using the Bethesda
nomenclature. Specimen adequacy is characterized as: -Satisfactory for evaluation (with quality indicators
if applicable) or -Unsatisfactory for evaluation, further subdivided as follows: - Specimen processed and
examined but unsatisfactory for evaluation of epithelial abnormality because of inadequate cellularity,
obscuring blood or inflammation, etc. - Specimen rejected because of a broken slide, unlabeled specimen,
etc. The diagnostic interpretation may include: -Negative for intraepithelial lesion or malignancy
-Atypical squamous cells of undetermined significance characterized further as either: - Atypical
squamous cells of undetermined significance or - Atypical squamous cells, cannot exclude high grade
intraepithelial lesion -Low grade squamous intraepithelial lesion, which includes mild squamous dysplasia
(cervical intraepithelial neoplasia I [CINI]) and koilocytotic changes consistent with HPV effect. -High
grade squamous intraepithelial lesion, which includes moderate squamous dysplasia (CINII), severe
squamous dysplasia (CINIII), and squamous carcinoma in situ (CINIII) -Atypical Glandular Cells Patients
with this diagnosis are at increased risk for a clinically significant lesion including adenocarcinoma in
situ, high-grade squamous intraepithelial lesion, invasive cervical carcinoma, or endometrial carcinoma
and should have appropriate clinical follow up that may include gynecologic examination, colposcopy, or
biopsy. The correlation from cytology to subsequent histologic examination is imprecise.
Reference Values:
Satisfactory for evaluation. Negative for intraepithelial lesion.
Note: Abnormal results will be reviewed by a physician at an additional charge.
Clinical References: 1. Wright TC Jr, Cox JT, Massad LS, et al: ASCCP-Sponsored Consensus
Conference. 2001 Consensus Guidelines for the management of women with cervical cytological
abnormalities. JAMA 2002 April;287(16):2120-9 2. Solomon D, Davey D, Kurman R, et al: The 2001
Bethesda System: terminology for reporting results of cervical cytology-Consensus Statement. JAMA
2002 April;287(16):2114-9
Cervical Papanicolaou Smear, Screening without Physician
Interpretation, 2 Slides
Clinical Information: Squamous cell carcinoma of the cervix is believed to develop in progressive
stages from normal through precancerous (dysplastic) stages, to carcinoma in situ, and eventually invasive
carcinoma. This sequence is felt to develop over a matter of years in most patients. The etiology of
cervical carcinoma is unknown, but the disease is believed to be related to sexual activity and possibly
sexually transmitted viral infections such as human papilloma virus (HPV). Most cervical carcinomas and
precancerous conditions occur in the transformation zone (squamo-columnar junction), therefore, this area
needs to be sampled if optimum results are to be obtained.
Useful For: Screening for cervical carcinoma and a number of infections of the female genital tract
including HPV, herpes, Candida, and trichomonas
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