The document discusses various tests used to screen for cervical dysplasia and cancer, including the Pap test and liquid-based cytology. It explains that the Pap test collects cervical cells on a slide, while liquid-based cytology places cells in preservative liquid. Both aim to detect abnormal cell changes, but liquid-based cytology provides a more concentrated sample through laboratory processing. The document also outlines other conditions that can affect the cervix, such as infections, polyps, and cervicitis.

1. DISEASE OF
UTERINE
CERVIX AND
VARIOUS
CYTOLOGY
TESTS
PRESENTED BY: PHINEHAS
OBENG ARHIN

2. INTRODUCTION TO UTERINE CERVIX.
This Photo by Unknown Author is licensed under CC BY-NC

3. CERVICAL DYSPLASIA
• Cervical dysplasia refers to abnormal changes in the cells of the cervix, which is the lower part of
the uterus that opens into the vagina. These changes are typically detected during a Pap test or
HPV test and are classified as mild, moderate, or severe based on the extent of abnormality.
• Mild dysplasia is also known as cervical intraepithelial neoplasia grade 1 (CIN 1) and is the most
common form of dysplasia. It often resolves on its own without treatment, but may require
follow-up testing.
• Moderate to severe dysplasia is classified as CIN 2 or CIN 3, respectively. These more significant
abnormalities have a higher chance of progressing to cervical cancer and are usually treated
with procedures such as a loop electrosurgical excision procedure (LEEP) or cone biopsy to
remove the abnormal cells.

4. IMPORTANCE OF SCREENING FOR CERVICAL
DYSPLASIA AND CERVICAL CANCER
• Screening for cervical dysplasia and cervical cancer is crucial because early detection and treatment
can significantly improve the chances of successful treatment and reduce the risk of developing
advanced-stage cervical cancer. Cervical cancer is one of the most preventable and treatable forms of
cancer, and regular screening can help detect any abnormal changes in the cells of the cervix before
they become cancerous.
• It's recommended that women start regular cervical cancer screenings at age 21, or earlier if they are
sexually active or have other risk factors. Depending on the results of the screening tests, further
testing or treatment may be necessary.
• Regular cervical cancer screening is particularly important for women who have a higher risk of
developing cervical cancer, such as those with a history of HPV infection, a weakened immune system,
or a family history of cervical cancer. Women who have received the HPV vaccine should still receive
regular cervical cancer screenings since the vaccine does not protect against all types of HPV that can
cause cervical cancer.

5. CERVICITIS
• Cervicitis is an inflammation of the cervix, which is the lower part of the uterus that connects to
the vagina. It can be caused by several factors, including infections (such as sexually transmitted
infections), allergic reactions to spermicides or condoms, or irritation from diaphragms or
cervical caps.
• Common symptoms of cervicitis include vaginal discharge (which may be clear, white, yellow, or
green), pain or discomfort during sex, vaginal bleeding outside of the menstrual cycle, and
pelvic pain or pressure. However, some people with cervicitis may not experience any symptoms.
• Cervicitis can be diagnosed through a physical examination, a pelvic exam, and laboratory tests,
including tests for sexually transmitted infections. Treatment depends on the underlying cause
and may involve antibiotics, antiviral medications, or anti-inflammatory drugs. It's essential to
get prompt and appropriate treatment for cervicitis to prevent complications and reduce the risk
of transmitting the infection to sexual partners.

6. CERVICAL POLYPS
• Cervical polyps are small growths that develop on the cervix, which is the lower part of the uterus that
connects to the vagina. They are typically noncancerous and can occur in women of any age but are
most common in women who have had children and are in their 40s or 50s.
• Cervical polyps can be asymptomatic, but they can also cause vaginal bleeding (especially after sexual
intercourse), discharge, and pelvic pain or pressure. They are usually diagnosed during a pelvic exam
or a Pap test, which involves collecting cells from the cervix for examination under a microscope.
• Treatment for cervical polyps depends on the size and location of the polyp and the severity of the
symptoms. Small polyps that are asymptomatic may not require any treatment, but larger polyps or
those that cause symptoms may need to be removed through a procedure such as a polypectomy,
which involves removing the polyp with a surgical instrument.
• Cervical polyps do not usually pose a significant health risk, but it's essential to get any unusual
symptoms checked by a healthcare provider to rule out other conditions and ensure timely treatment
if necessary.

7. CERVIX-RELATED INFECTIONS
Some common cervix-related infections include:
Human papillomavirus (HPV): HPV is a sexually transmitted infection that can cause genital warts and
increase the risk of cervical cancer.
Chlamydia: Chlamydia is a bacterial infection that can cause cervicitis (inflammation of the cervix) and
increase the risk of pelvic inflammatory disease (PID) if left untreated.
Gonorrhea: Gonorrhea is a bacterial infection that can cause cervicitis and increase the risk of PID if left
untreated.
Trichomoniasis: Trichomoniasis is a parasitic infection that can cause cervicitis and vaginal discharge.
Bacterial vaginosis: Bacterial vaginosis is a bacterial infection that can cause cervicitis and vaginal
discharge.

8. CONVENTIONAL SMEAR FOR CYTOLOGICAL EXAM
(PAP TEST)
• Pap test, is a simple and routine screening test for cervical cancer that involves
collecting cells from the cervix and examining them under a microscope to detect any
abnormal changes. The procedure typically takes only a few minutes and is performed
during a pelvic exam.
• During a conventional smear, we use a speculum to open the vagina and view the
cervix. We will then use a small brush or spatula to collect cells from the surface of the
cervix. The cells are then placed on a glass slide, which is sent to a laboratory for
examination under a microscope.
• It's recommended that women start regular Pap tests at age 21 or within three years
of becoming sexually active, whichever comes first. The frequency of testing depends
on several factors, including age, risk factors, and previous test results.

9. LIQUID-BASED CYTOLOGY (BETHESDA SYSTEM)
• Liquid-based cytology is a newer method of screening for cervical cancer that involves
collecting cells from the cervix using a brush or spatula and placing them in a liquid
medium, rather than directly onto a glass slide as in a conventional Pap test. This
method is also known as the Bethesda system, named after the Bethesda Workshop
that created the classification system for reporting cervical cytology results.
• With liquid-based cytology, the collected cells are processed in a laboratory to
remove mucus, blood, and other debris, leaving a more concentrated sample of cells
for examination under a microscope. This method may result in fewer inadequate or
unsatisfactory samples, which can occur with conventional smears due to poor
specimen quality or obscuring factors.

10. THE BETHESDA SYSTEM
• It is a standardized classification system that provides guidelines for reporting cervical
cytology results, including those from liquid-based cytology.
The system divides the results into different categories, ranging from "negative for
intraepithelial lesion or malignancy" to "high-grade squamous intraepithelial lesion"
(HSIL) or "carcinoma." These categories help determine the appropriate follow-up and
management for abnormal results, such as additional testing or treatment.
• The liquid-based cytology method and Bethesda system have several potential
benefits, including improved accuracy, reduced need for repeat testing, and
standardized reporting of results. However, the method may be more expensive than
conventional smears and may not be available in all areas or healthcare settings.

11. COMPARISON BETWEEN CONVENTIONAL SMEAR
AND LIQUID-BASED CYTOLOGY
Collection Method:
• Conventional smear: A brush or spatula is used to collect cells from the surface of the cervix and
spreads them directly onto a glass slide.
• Liquid-based cytology: A brush or spatula is used to collect cells from the cervix and places the
collected cells in a vial of preservative liquid.
Processing Method:
• Conventional smear: The collected cells are air-dried on the glass slide and then stained with a dye to
make the cells visible under a microscope.
• Liquid-based cytology: The vial containing the collected cells is sent to a laboratory, where the cells are
processed to remove mucus, blood, and other debris, leaving a more concentrated sample of cells for
examination under a microscope.

12. COMPARISON BETWEEN CONVENTIONAL SMEAR
AND LIQUID-BASED CYTOLOGY
Advantages:
• Conventional smear: It is a simple and inexpensive method that has been used for many years
and is widely available.
• Liquid-based cytology: It can reduce the number of inadequate or unsatisfactory samples due to
poor specimen quality and can provide a standardized method of reporting results.
Disadvantages:
• Conventional smear: The sample may be affected by blood, mucus, or other substances that can
obscure the cells and affect the accuracy of the results.
• Liquid-based cytology: It can be more expensive than conventional smears and may not be
available in all areas or healthcare settings.