Identification

Low-grade squamous intraepithelial lesions (LGSIL) are abnormal growths of epithelial cells on the surface of the cervix, which can be identified with using a Pap test. These lesions are not cancer but can potentially develop into cancer if left untreated. LGSIL is considered to be in the early stages, often caused by HPV, whereas high-grade squamous intraepithelial lesions (HGSIL) are more severe and precancerous. LGSIL is identified in approximately 2-3% of all Pap tests.

Laser Ablation

Carbon dioxide laser ablation is used to address pathological conditions in the cervix, vagina, or vulva. The laser destroys abnormal cells, allowing healthy cells to replace them.

Loop Electrosurgical Excision Procedure (LEEP)

LEEP is a minor procedure performed in the Health Care Provider’s office, during which a piece of the cervix is removed and sent for histological examination (conical biopsy). LEEP is also used to address abnormal cells and tissue in the cervix. This procedure uses a thin wire that acts as a surgical scalpel when heated by electrical current to cut the tissue.

Important Questions to Ask Your Health Care Provider

• Based on my gynecological history and Pap test results, what options do I have? What tests should I take and what steps should I follow?

• What do you recommend I do next and for what reason?

• What are the possible risks or side effects/complications?

• When should I repeat the Pap test?

Pap Test

All sexually active women should have a gynecological examination at least once a year. The annual examination includes the Pap test. HPV infection is one of the most common sexually transmitted diseases and a leading cause of precancerous lesions and cervical cancer. The Pap test involves examining cells collected from the vagina and cervix. Early detection of cervical cancer increases the chances of successful treatment.

Historical Context

• George Papanicolaou discovered the Pap test in 1928.

• The number of women identified with cervical cancer has dropped by approximately 70% due to the Pap test.

• Most deaths from cervical cancer occur when women do not have regular check-ups, and early symptoms are not detected.

• The American Cancer Society estimates that more than 13,000 women are identified with cervical cancer each year.

• 90% of women identified with cervical cancer will survive for at least five years.

• Risk factors for cervical cancer include HPV infection, early age at first sexual intercourse, a history of many sexual partners, smoking, habits affecting the immune system, and HIV infection.

Investigation

The Pap test, which involves taking a small sample of cells from the vagina and cervix, can detect precancerous and cancerous lesions caused by HPV. Your gynecologist will evaluate the test results. If the identification indicates the presence of ASC–US, you should repeat the Pap test after three or six months. If you have any infection, you must follow the recommended steps and then repeat the Pap test.

Colposcopy

Colposcopy is a procedure to closely examine your cervix, vagina, and vulva for signs of disease if your Pap test result is abnormal. This diagnostic procedure uses a colposcope to magnify the external genitalia, vagina, and cervix, allowing for the evaluation of pathological conditions. The procedure usually lasts a few minutes and feels like a Pap test.

Biopsy

If cellular lesions are observed in a certain area of the cervix during colposcopy, the gynecologist will take directed biopsies for further examination. This involves removing a small piece of tissue (or more if necessary) and sending it to the laboratory for histological analysis.

Cervical Ablation

Cervical ablation involves removing some of the outer layers of the cervix. The gynecologist takes cells from the endocervix and sends them to the laboratory for further investigation of abnormalities when there is suspicion or evidence of cancer. Endocervical ablation and biopsy are often combined.

Important Questions to Ask Your Health Care Provider

• Based on my gynecological history and Pap test results, what options do I have? What tests should I take and what steps should I follow?

• What do you recommend I do next and for what reason?

• What are the possible risks or side effects/complications?

• When should I repeat the Pap test?