Topic Overview
What is an abnormal Pap test?
A
Pap test, or Pap smear, is part of a woman's routine
physical exam. It is the best way to prevent
cervical cancer, because it can find cells on your
cervix that could turn into cancer. The cervix is the
lower part of the uterus that opens into the vagina.
When your
doctor says that your Pap test was "abnormal," it means that the test found
some cells on your cervix that do not look normal. It does not mean that you
have cancer. In fact, the chances that you have cancer are very small.
What causes an abnormal Pap test?
Most of the
time, abnormal cell changes on the cervix are caused by certain types of
human papillomavirus, or HPV. HPV is a
sexually transmitted infection. Usually these cell
changes go away on their own. But certain types of HPV have been linked to
cervical cancer. That’s why it’s important for women to have regular Pap tests.
It usually takes many years for cell changes in the cervix to turn into cancer.
Sometimes cell changes in the cervix are due to other types of infection,
such as infections caused by bacteria or yeast. These types of cell changes can
be treated. In women who have been through menopause, a Pap test may find cell
changes that are just the result of getting older.
What increases your risk for an abnormal Pap test?
High-risk sex raises your chances of getting HPV and having an abnormal
Pap test. High-risk sex includes having sex without condoms and having more
than one sex partner (or having a sex partner who has other partners).
HPV can stay in your body for many years without your knowing it. So even
if you now have just one partner and practice safe sex, you could still have an
abnormal Pap test if you were exposed to HPV in the past.
Smoking
or having an
impaired immune system also may raise your chances of
having cell changes in your cervix.
Do abnormal cell changes cause symptoms?
The cell
changes themselves don't cause symptoms. HPV, which causes most abnormal Pap
tests, usually doesn't cause symptoms either. This is why regular Pap tests are
so important.
If a different sexually transmitted infection is the cause of your abnormal Pap test, you may have symptoms,
including:
- A discharge from the vagina that isn't normal
for you, such as a change in the amount, color, odor, or texture.
- Pain, burning, or itching in your pelvic or genital area when you
urinate or have sex.
- Sores, lumps, blisters, rashes, or warts on
or around your genitals.
What will you need to do if you have an abnormal Pap test?
You will need more tests to find out if you have an
infection or to find out how severe the cell changes are. These tests may
include:
-
Colposcopy
, a
test to look at the vagina and cervix through a lighted magnifying tool.
- An HPV test. Like a Pap test, an HPV test is done on a sample of
cells taken from the cervix.
- Another Pap test in 4 to 6
months.
A colposcopy is usually done before any treatment is
given. During a colposcopy, the doctor also takes a small sample of tissue from
the cervix so that it can be looked at under a microscope. This is called a
biopsy.
Treatment, if any, will depend on whether your abnormal
cell changes are mild, moderate, or severe. In moderate to severe cases, you
may have treatment to destroy or remove the abnormal cells.
Frequently Asked Questions
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Cause
Most
abnormal Pap tests are caused by
human papillomavirus (HPV) infections. Other types of
infection—such as those caused by bacteria, fungi (yeast), or protozoa
(Trichomonas)—sometimes lead to minor changes on a Pap
test called atypical squamous cells of undetermined significance (ASC-US). The most common cause is HPV infection.
Natural cervical cell changes (atrophic vaginitis) related to
menopause can also cause an abnormal Pap test.
Symptoms
Because
cervical cell changes that can cause an
abnormal Pap test rarely cause symptoms, regular Pap
test screening to monitor cell changes is important.
Human papillomavirus (HPV)
infection, which is the
most common cause of abnormal cervical cell changes, usually does not cause any
symptoms.
A number of
infections and
sexually transmitted infections (STIs) can cause an
abnormal Pap test. STIs can have a variety of symptoms, including:
- A change in vaginal discharge (thicker,
discolored, or bad-smelling) over a period of several days to 2
weeks.
- Pain, burning, or itching while urinating that lasts more
than 24 hours.
- Pain during sexual intercourse.
- Pain in
the pelvic or lower abdominal area.
- Itching, tingling, burning, or
pain on the genitals.
- Sores, lumps, blisters, rashes, or warts on
or around the genitals.
Only a small percentage of abnormal Pap tests indicate
cervical cell changes that may progress to cervical cancer.
Symptoms of
cervical cancer may include:
- Abnormal vaginal bleeding or a significant
unexplained change in your
menstrual cycle.
- Bleeding when something
comes in contact with the cervix (such as during sexual intercourse or
insertion of a diaphragm).
- Abnormal vaginal discharge containing
mucus that may be tinged with blood.
- Pain during intercourse.
What Happens
The cervix contains two kinds of cells:
rectangular-shaped columnar cells on the surface of the cervix and in the
cervical canal; and flat, scalelike squamous cells on the surface of the
cervix. Columnar cells are constantly changing into squamous cells
in an area of the cervix called the
transformation zone.
Abnormal Pap test results
can be caused by infection,
which leads to cell changes in the
transformation zone of the
cervix. Pap test results often return to normal when
the cells have returned to healthy growth or after an infection has been
treated or has resolved on its own.
In some cases, untreated
cervical cell changes that cause abnormal Pap tests may progress to
precancerous or cancerous stages. Certain high-risk types of the
human papillomavirus (HPV) have been linked to the
development of
cervical cancer. But changes in cervical cells usually
progress slowly and take many years to become cancer cells. Treatment can
remove or destroy these cells before they become cancerous.
Regular Pap test screening can detect cervical cell changes
early.
- Minor cell changes often go away without
treatment.
- Early detection of precancerous cell changes or cervical
cancer usually makes a complete cure possible.
- If a high-risk type
of HPV is diagnosed, more frequent Pap tests or other testing (such as
colposcopy or
cervical biopsy) may be needed for further
evaluation.
Cervical polyps are unrelated to cervical cancer, but
they may be found and removed at the time of a pelvic exam and Pap test.
What Increases Your Risk
Most cervical cell changes
that cause an
abnormal Pap test are the result of sexual
transmission of HPV disease. High-risk sexual behaviors by you or your partner
at some time, possibly even many years ago, may lead to HPV infection.
High-risk sexual behaviors increase your risk of infections and
sexually transmitted infections (STIs).
Other
risk factors that may also play a role in increasing your risk for cervical
cell changes include:
If you have had one abnormal Pap test result, you may be at
higher risk for having another abnormal Pap test in the future.
When To Call a Doctor
Most problems that cause
abnormal Pap tests do not cause symptoms, so you won't
know you have cervical cell changes. Regular Pap testing is needed to detect
early cervical cell changes.
Call your doctor if:
- You have unexpected bleeding between menstrual
periods, especially if you are not using any hormonal contraceptives, such as
birth control pills.
- You have bleeding after douching or sexual
intercourse.
If you think you may have
symptoms of a sexually transmitted infection (STI), call
your doctor for an appointment. Avoid sexual intercourse
until you have been treated for your symptoms and can no longer infect your
partner.
If your sex partner has symptoms of an STI, both of you
should be evaluated by a doctor. If you have been diagnosed with an STI, such
as genital warts, your
sex partner(s) may want to be evaluated.
If you have had an abnormal Pap test, be certain
to complete any additional testing or treatment that your doctor recommends.
You and your doctor can decide how often Pap test screening should continue or
whether other tests are needed.
Who to see
Your family doctor or any of the following health
professionals can manage an abnormal Pap test:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
You may have a
Pap test as part of your routine gynecologic exam. A
Pap test is used to identify abnormal cell changes on your
cervix and to screen for
cervical cancer. Pap test screening is the most
effective way to detect early abnormal cervical cell changes.
Women older than age 30 may have a screening test for HPV infection at
the same time they have their Pap test.1
Pap test screening schedule
The recommended Pap test schedule is based on your age and on things that increase your risk. For most women, it is best to have a Pap test every 1 to 3 years. Talk to your doctor about when to have your first Pap test and how often to have this test.
Abnormal Pap test result
If your Pap test result is abnormal, the lab will use
the Bethesda system (TBS) to describe how severe the problem is. Your doctor will use these results to decide how to treat the problem.
Following an abnormal Pap test
result, more tests may be needed to determine whether an infection is
present or to determine the severity of cervical cell changes. These additional
tests include:
-
Human papillomavirus (HPV) DNA test. HPV testing is
done to identify high-risk types of HPV infection. If your abnormal Pap test is
caused by HPV, knowing whether you have a high-risk type of HPV can help guide
your evaluation and treatment decisions.
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Colposcopy and cervical biopsy. A colposcopy uses a magnifying instrument
called a colposcope to look at the vagina and the cervix. Cell
abnormalities (dysplasia) that might be missed by the naked eye can
be seen with the colposcope. A cervical biopsy removes a small piece of the cervix so the
tissue can be examined under a microscope.
-
Cone biopsy. This is an extensive form of a cervical
biopsy. It is called a cone biopsy because a cone-shaped wedge of tissue is
removed from the cervix and examined under a microscope. A cone biopsy may also
serve as treatment by removing the abnormal cervical cells.
For more information, see:
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Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?
For information on tests to diagnose a specific
infection, see the specific topic:
What to think about
Testing methods,
such as
liquid-based collection, are being used in many areas
of the United States. Liquid-based collection methods allow testing for HPV at
the same time as a Pap test, but these methods may not be available everywhere and
may be more costly.
The terms used to report Pap test results vary
depending on which classification system is used. The Bethesda system (TBS) is
used by most labs in North America. Other classification systems are used
around the world.
Treatment Overview
Even though most
abnormal Pap tests are caused by an
HPV infection that will go away or by an inflammation
that can be treated, you will need a follow-up evaluation to make sure your
abnormal cell changes have resolved. Your need for treatment will vary
depending on whether your abnormal cell changes are mild, moderate, or severe.
Abnormal Pap test results may show minor cell changes (most common), moderate
to severe cell changes (less common), or
cervical cancer (rare). Depending upon the cause and
severity of the cervical cell changes,
you may need treatment.
If your Pap test shows that a vaginal infection or a treatable
sexually transmitted infection (STI) is present, you can
be treated with medicine.
Human papillomavirus (HPV) infection is the most
common cause of an abnormal Pap test. There are many types of HPV. High-risk
types can cause cell changes that could develop into cancer.
Evaluation of minor cell changes (ASC-US and LSIL)
An abnormal Pap test result is not uncommon because HPV infection is
very common. Most cell changes seen in abnormal Pap test results will not
progress to cervical cancer. If your abnormal Pap test shows
minor cell changes, you may have several choices of what to do next.
Based on your age and the type of cell changes found, your doctor may recommend:
-
Watchful waiting, which includes repeat Pap tests
about every 6 months, or less often if you are under 21. Watchful waiting will not be harmful if the abnormal
tissue is not visible on the cervix or a type that is not likely to progress to
cancer and you do not have an
impaired immune system.
- A test for high-risk human papillomavirus (HPV) types.
The natural course of most types of HPV is to resolve on their own within 18
months. HPV in women younger than 30 usually goes away on its own. HPV in women
older than 30 is more likely to persist.
- A colposcopy so your doctor can look at the abnormal
cells. A
cervical biopsy may be done at the same time to
confirm the colposcopy findings. Women with HIV infection will most likely be
evaluated with colposcopy and then treated for any abnormal cervical
cells.
For more information, see:
-
Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?
Treatment for moderate to severe cell changes (HSIL, ASC-H, or AGC)
Treatment decisions for an abnormal Pap test that shows
moderate to severe cell changes are based on the Pap
test results, colposcopy, and cervical biopsy. A larger tissue sample may be
removed by a
cone biopsy. In some cases, this procedure may serve
as treatment so you are cured. Follow-up to evaluate and treat moderate to
severe cervical cell changes is recommended sooner than for minor cell changes.
For moderate or severe precancerous cell
changes confirmed by biopsy, treatment will focus on destroying or removing the
abnormal tissue. Treatment choices include
LEEP, a surgery that uses a thin wire loop to remove
the abnormal tissue;
cryotherapy, which destroys tissue by freezing it;
laser therapy, which destroys tissue with a laser
beam; or
cone biopsy (conization), in which a cone-shaped piece
of abnormal tissue is removed from the cervix.
For
cervical cancer, treatment will focus on destroying or
removing the cancerous tissue. For more information, see the topic
Cervical Cancer.
Treatment for an abnormal Pap during pregnancy
A
Pap test may be done during pregnancy if a woman is due for her regular
screening test. A
pregnant woman with an abnormal Pap test is monitored
closely throughout her pregnancy. Monitoring may include evaluation by
colposcopy. The goal of evaluation is to rule out
cervical cancer, a rare diagnosis. Treatment for abnormalities other than
cancer is done after delivery.
Prevention
You cannot prevent an
abnormal Pap test, but you can reduce your risk
factors.
Have regular Pap test screening
The Pap test is
the most effective screening test to prevent the development of
cervical cancer. Pap tests done at regular intervals
almost always detect cervical cell changes before the changes become cancerous.
Regular screening for and treatment of cervical cell abnormalities can prevent
the abnormal cell changes from developing into cancer.
The recommended Pap test schedule is based on your age and on things that increase your risk. For most women, it is best to have a Pap test every 1 to 3 years. Talk to your doctor about when to have your first Pap test and how often to have this test.
Quit smoking
Women who smoke are at higher risk
for developing cervical cell changes that cause an abnormal Pap test. The
reason for this is not fully understood. Quitting smoking may decrease this
risk. Not smoking has many other health benefits. For example, nonsmokers have
a lower risk of other cancers and heart disease. For more information, see the
topic
Quitting Smoking.
Reduce your risk of a sexually transmitted infection (STI)
Sexually transmitted infections
(STIs), especially
HPV infection, often cause abnormal Pap tests and can
lead to other serious health problems. Preventing an STI is easier than
treating an infection after it occurs.
- Talk with your partner about STIs before
beginning a sexual relationship. Find out whether he or she is at risk for an
STI. Remember that it is quite possible to be infected with an STI without
knowing it. Some STIs, such as
HIV, can take up to 6 months before they are detected
in the blood. Consider HIV testing if you or your partner are at risk for
HIV.
- Be responsible.
- Avoid sexual contact if you have symptoms
of an STI or are being treated for an STI.
- Avoid all intimate
sexual contact with anyone who has symptoms of an STI or who may have been
exposed to an STI.
- Use
male or
female condoms to reduce the risk of getting an STI.
Using male condoms when you have sex has been shown to reduce your risk of
getting HPV.2 Female condoms may help also, although
there has been less study of this type of protection.
- Abstaining from sexual intercourse is the only way to
completely prevent any exposure to STIs.
Your risk for an STI increases if you have several sex
partners at the same time or if your sex partner has more than one
partner.
The vaccines Cervarix(What is a PDF document?) and Gardasil(What is a PDF document?) protect against two types of HPV that cause cervical cancer. Gardasil also protects against two types of HPV that cause genital warts. Three shots are given over 6 months. It is recommended for children age 11 or 12 but can be given as early as age 9. For girls who have not already gotten the vaccine, it is recommended up to age 26. For boys who have not already gotten the shot, the vaccine is recommended up to age 21. Gardasil is used for males. Females can get either vaccine. For more information,
see the topic
Immunizations.
For more information on
getting your child vaccinated, see:
-
HPV: Should My Child Get the Vaccine?
Home Treatment
All
abnormal Pap tests require follow-up. In some cases,
you may need further testing or treatment. In other cases, your doctor may
recommend a period of
watchful waiting that includes repeat Pap
tests.
- Be certain to complete any further testing
that your doctor recommends. This includes repeat Pap tests as well as any
other tests.
- If a vaginal infection or a treatable
sexually transmitted infection (STI) caused your
abnormal test results, you will probably need medicine. Take all the medicine
as directed by your doctor. If you skip doses or do not take all your medicine,
the problem may come back.
To reduce your risk of cervical problems:
- Have regular Pap tests. Regular Pap tests
almost always detect cervical cell changes before the changes become cancerous.
Regular screening for and treatment of cervical cell abnormalities can prevent
cancer. You and your doctor can decide how often you need to be
tested.
- Reduce your risk of exposure to sexually transmitted
infections by practicing safer sex. Use condoms until you are certain that
neither you nor your partner has an STI. To prevent STIs, condoms must be put
on before beginning any sexual contact.
- Quit smoking. Women who smoke are at higher risk of developing
cervical cell changes that cause an abnormal Pap test. The reason for this is
not fully understood.
Medications
Medicines may cure a bacterial, fungal,
or protozoal infection and allow
minor cell changes called atypical squamous cells of undetermined significance
(ASC-US) that have caused an
abnormal Pap test to return to normal. HPV infection
cannot be treated with medicine. The infection or inflammation changes of
cervical cells are monitored in the following sequence:
- If an infection is identified, even though you
may not have symptoms, nonprescription or prescription medicine may be
recommended to eliminate the infection. The type of medicine used depends on
the type of infection present. For more information on treatment for a specific
infection, see the appropriate topic:
Chlamydia,
Gonorrhea,
Syphilis,
Trichomoniasis,
Vaginal Yeast Infections,
Bacterial Vaginosis,
Genital Herpes, or
Genital Warts (Human Papillomavirus).
- The
Pap test is repeated at regular intervals as recommended by your doctor. If the
repeat Pap test results are normal after the treatment of an infection, you can
return to your normal Pap test screening schedule.
- If the Pap test
remains abnormal after treatment, you and your doctor may choose
watchful waiting. Or a
colposcopy may be done to diagnose the cause of the
abnormal test. Regular Pap testing allows you to monitor minor cervical cell
changes.
Estrogen cream. Women near
menopause may have abnormal Pap test results because
of normal body changes during menopause, such as cervical cell atrophy and
estrogen loss. These minor cell changes may improve with the use of estrogen
cream.
Surgery
If you have had an
abnormal Pap test, surgery may be an option. Surgical
treatment may be recommended if:
Surgery may be done to destroy or remove the abnormal cells
on your cervix, or confirm or rule out the possibility that you have cervical
cancer.
Abnormal tissue that can be seen through the magnifying
viewing instrument (colposcope) can often be destroyed or removed with
cryotherapy, a cone biopsy, a carbon dioxide (CO2) laser, or the loop
electrosurgical excision procedure (LEEP).
Abnormal cervical cells
that are detected by a Pap test but cannot be seen by colposcopy may be high in
the cervix (cervical canal). Before treatment is recommended, the location and
type of cell change must be confirmed by a cervical biopsy. Depending on the
results of the colposcopy and cervical biopsy, a
cone biopsy may be done as the next step.
Surgery choices
Surgical choices for abnormal cervical cell changes
include the following:
Procedures that remove abnormal tissue
-
Cone biopsy (conization) removes a cone-shaped wedge of abnormal cells high in the
cervical canal. A small amount of normal tissue around the cone-shaped wedge of
abnormal tissue is also removed so that a margin free of abnormal cells is left
in the cervix.
-
Loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to cut out
abnormal cervical cells. It can also be used to remove a cone-shaped wedge of
tissue like a cone biopsy.
Procedures that destroy abnormal tissue
-
Cryotherapy
destroys abnormal cervical cells by freezing them.
-
Carbon dioxide laser uses a laser beam to destroy
(vaporize) abnormal cervical cells. It can also be used to remove a cone-shaped
wedge of tissue like a cone biopsy.
If the results of a Pap test, colposcopy, and
cervical or cone biopsy point to invasive cervical cancer, then surgery,
radiation, chemotherapy, or a combination of treatments will be needed to
destroy or remove the cancerous tissue.
For more information, see the topic
Cervical Cancer.
What to think about
Minor cell changes may not need
to be treated with surgery. When deciding on treatment for minor cell changes,
consider the following:
- Infections may be cured with medicines for
the specific cause of the infection.
- Minor cell changes often go
away without treatment. Your doctor may suggest a period of
watchful waiting before further evaluation or a biopsy
is recommended. Surgery may be needed if the cell changes are confirmed by
biopsy to be progressing to more severe cell changes. Surgery may also be done
if follow-up evaluation is not possible or immediate treatment is
wanted.
- Cell changes caused by
human papillomavirus (HPV) infection may not progress
beyond mild changes. The natural course of most types of HPV is for the cells
to change back to normal within 18 months without treatment. Cervical cell
changes caused by HPV may be treated because of their degree of abnormality,
but treatment does not eliminate the virus. You may still have HPV inside your
body's cells.
Treatment choices for moderate to severe cell changes are
more likely to include surgery to specifically destroy or remove the abnormal
tissue.
Other Treatment
Removal of the uterus (hysterectomy) may be a treatment choice for some women
who have had an
abnormal Pap test if both of the following are
true:
- They are done having children.
-
They have other gynecological problems, such as heavy irregular bleeding that
does not improve with medicine, that would also be treated with a
hysterectomy.
Other Places To Get Help
Organizations
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American Congress of Obstetricians and Gynecologists
(ACOG)
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| 409 12th Street SW |
| P.O. Box 70620 |
| Washington, DC 20024-9998 |
| Phone: |
1-800-673-8444 |
| Phone: |
(202) 638-5577 |
| Email: |
resources@acog.org |
| Web Address: |
www.acog.org |
| |
|
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking.
|
|
|
Association of Reproductive Health Professionals
(ARHP)
|
| 2401 Pennsylvania Avenue NW |
| Suite 350 |
| Washington, DC 20037-1718 |
| Phone: |
(202) 466-3825 |
| Fax: |
(202) 466-3826 |
| Web Address: |
www.arhp.org |
| |
|
This organization of health professionals provides education and
information on reproductive health matters such as sexual health, sexually
transmitted diseases (STDs), family planning, contraception, and
infertility.
|
|
|
Centers for Disease Control and Prevention (CDC):
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention
|
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: |
1-800-CDC-INFO (1-800-232-4636) |
| TDD: |
1-888-232-6348 |
| Email: |
cdcinfo@cdc.gov |
| Web Address: |
www.cdc.gov/nchstp |
| |
|
The National Center for HIV/AIDS, Viral Hepatitis, STD,
and TB Prevention is a branch of the Centers for Disease Control and Prevention
(CDC). Its website provides information and updates on sexually transmitted
diseases (STDs), human immunodeficiency virus (HIV), and tuberculosis (TB). You
can also find fact sheets on these health topics.
|
|
|
National Women's Health Network
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| 514 10th Street NW |
| Suite 400 |
| Washington, DC 20004 |
| Phone: |
(202) 347-1140 |
| Fax: |
(202) 347-1168 |
| Email: |
nwhn@nwhn.org |
| Web Address: |
www.womenshealthnetwork.org/ |
| |
|
This nonprofit advocacy group includes consumers, health
centers, and organizations. The National Women's Health Network monitors
federal health policy and operates an information clearinghouse.
|
|
References
Citations
-
American College of Obstetricians and Gynecologists
(2005, reaffirmed 2009). Human papillomavirus. ACOG Practice Bulletin No. 61.
Obstetrics and Gynecology, 104(4): 905–918.
-
Winer RL, et al. (2006). Condom use and the risk of genital human papillomavirus infection in young women. New England Journal of Medicine, 354(25): 2645–2654.
Other Works Consulted
- American College of Obstetricians and Gynecologists
(2012). Screening for cervical cancer. ACOG Practice Bulletin
No. 131. Obstetrics and Gynecology, 120(5):
1222–1238.
- ASCUS–LSIL Triage Study (ALTS) Group (2003). A
randomized trial on the management of low-grade squamous intraepithelial lesion
cytology interpretations. American Journal of Obstetrics and Gynecology, 188(6): 1393–1400.
- Cox JT, et al. (2003). Prospective follow-up suggests
similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3
among women with cervical intraepithelial neoplasia grade 1 or negative
colposcopy and directed biopsy. American Journal of Obstetrics and Gynecology, 188(6): 1406–1412.
- Cuzick J, et al. (2003). Management of women who test
positive for high-risk types of human papillomavirus: The HART study.
Lancet, 362 (9399): 1871–1876.
- Guido R, et al. (2003). Postcolposcopy management
strategies for women referred with low-grade squamous intraepithelial lesions
or human papillomavirus DNA–positive atypical squamous cells of undetermined
significance: A two-year prospective study. American Journal of Obstetrics and Gynecology, 188(6): 1401–1405.
- Wright TC, et al. (2003). 2001 consensus guidelines
for the management of women with cervical intraepithelial neoplasia.
American Journal of Obstetrics and Gynecology, 189(1):
295–304.
- Wright TC, et al. (2007). 2006 consensus guidelines
for the management of women with abnormal cervical cancer screening tests.
American Journal of Obstetrics and Gynecology, 197(4):
346–355.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Sarah Marshall, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Kirtly Jones, MD - Obstetrics and Gynecology |
|
Last Revised
|
February 9, 2012 |