The cells are examined under a microscope to look for not only cervical cancer, but. Effect of progesterone on the interpretation of cervical smear dr. Understanding your pap smear cervical screening test results. Pap clinic newfoundland and labrador medical association. We do not anticipate that consultants should need to change their site investigation. Medical coding and billing the pap test basic rules. If the hpv test is positive and you are older than 25, your doctor will order a colposcopy.
Ontario cervical screening program screening initiation women should begin screening for cervical cancer at age 21 if they are or have ever been sexually active. However, two modifications have been made since the introduction of bts and changes in the terminologies and definitions may cause confusion. The papanicolaou test abbreviated as pap test, also known as pap smear, cervical smear, cervical screening, or smear test is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix opening of the uterus or womb or colon in both women and men. Pap smears, cytology and cchc lab work and follow up. A pap smear is the typical screening procedure, but when a pap smear is combined with a test for human papillomavirus hpv, the known cause of cervical cancers, screening every 5 years is acceptable for women aged 30 and above. Papanicolaou stain also papanicolaous stain or pap stain is the most important stain utilized in the practice of cytopathology. Family medicine and obgyns practices regularly have women come in for their pap and pelvic exam. Spread material evenly onto labeled glass slide and fix immediately. During a pap smear cells from the cervix are examined for.
It is a polychromatic stain containing multiple dyes to differentially stain various components of the cells. Papanicolaou test also called pap smear, pap test, cervical smear, or smear test is a screening test used to detect potentially precancerous and cancerous processes in the the endocervical canal transformation zone of the female reproductive system. The pap smear is a screening procedure that tests for cervical cancer. Many women feel anxious or worried when they are told their pap test result is not completely normal. A pap smear, also called a pap test, is a routine screening procedure for cervical cancer.
The pap test is a highly complex laboratory test requiring careful patient preparation, skill in clinical collection, highly skilled and. A pap smear involves collecting cells from your cervix the lower, narrow end of your uterus thats at the top of your vagina. The cervix may also be going through some changes called dysplasia. Pengertian pap smear adalah suatu tes yang aman dan murah dan telah dipakai bertahuntahun lamanya untuk mendeteksi kelainankaelainan yang terjadi pada selsel leher rahim fitria, 2007. The pap test is a highly complex laboratory test requiring careful patient preparation, skill in. It is important to remember that almost all abnormal pap test results are not due to cancer. Interpretation depends on the number of cells that are shedding at the time the smear is taken. Management of abnormal pap smear clinical practice. The pap smear test has now changed to the cervical screening test. Effective 112017, hmsas commercial plans include laboratory benefits for one routine screening pap smear every 3 calendar years for women beginning at age 21 years old through age 65 years old. Its recommended once every three years for women starting at age 21, regardless of whether or not you.
Resources on pap and hpv testing and triage algorithms can be found on the american society of colposcopy and cervical pathology asccp website via links on both pages. Management algorithms for abnormal cervical cytology and. Gyenocologic pap test collection procedure medical. The most common nongyn cytology specimens submitted are washings, such as bronchial, bladder, esophageal. Pap smear screening in the primary health care setting. All women who have ever had sexual intercourse are advised to start having pap tests two years after they started having sex or at the age of 18. Lab report formatting for pap smears narrative lab reports such as pap smears have long been a frustration for emrs. He or she may also have you come back in 6 to 12 months for another pap test. Residents ppap smearap smear bioline international. Pap smears women between the ages of 21 and 29 should have a pap test every 3 years. A pap smear is usually a part of a pelvic examination and is accompanied by a breast examination conducted by a gynecologist.
The text in this monograph is concise and contains relevant information for cytologic interpretation of cell samples from the abovementioned anatomic sites. The best way to detect cervical cancer is by having regular papanicolaou tests pap smears, or cervical cytology. Papanicolaou smear, to be submitted for publication in a belgian medical journal. The pap test and bethesda 2014 american cancer society. Screening pap tests and pelvic examinations mln booklet page 3 of icn mln909032 june 2019. Vaccinate for hpv through age 26 regardless of pap or sexual history 3064 pap and hpv cotesting every 3 years note. Management of abnormal pap smear clinical practice guideline. A pap test is a simple and quick screening test conducted to obtain a smear of vaginal or cervical cells for cytological study. Jaya shankar, md nims associate professor, department of pathology, kamsrc, lb nagar, hyd68. Clear, readable, illustrated booklet summarising the conclusions of the three working groups consistency in cervix cytology methods, followup, sampling.
All powder should be wiped off gloves before spatulas are handled since presence of starch granules will make interpretation of slides difficult. The pap smear has been the method of choice for cervical cancer screening since the 1950s, proving valuable for mass screening and enabling detection of lesions early enough for effective treatment. Physician hematology services include microscopic evaluation of bone marrow aspirations and biopsies. Department of health and human services health resources and services administration. Pregnancy does not prevent a woman from having a pap smear, therefore, pap smears can be safely done during pregnancy. If your screening found ascus, your doctor will probably order an hpv test. The guidelines generally advise a reduction in the number of tests women get over their lifetime to better ensure that they receive the benefits of testing while minimizing the harms, and include a preference for cotesting using the pap test and hpv test for women age ages 30 to 65. Interpretation of pap smear a pap smear that appears abnormal requires interpretation by a physician, but some pathologists find it difficult to receive fair payment for it, especially if the payer is medicare. The pap smear is a screening test and should not be used as the sole means of detecting cervical cancer. While an abnormal pap smear may be a sign of cancer, many different changes on the cervix can cause an abnormal pap smear. Coding for cytology specimens proper cpt reporting of a nongyn cytology specimen depends principally on the type of preparation thats performed for screening and examination.
If more than one slide is immersed in fixation solution, attach a paper clip to each slide to. Important preventive health care for women includes screening pap tests and pelvic examinations. Women who are not sexually active by age 21 should delay cervical cancer screening until they are sexually active. Interpretation of pap smear reports bts has been developed to improve the communication between cytopathologists and clinicians so that the latter can be better informed on the findings on the slides. A pap smear also known as the pap test is a medical procedure in which a sample of cells from a womans cervix the end of the uterus that extends into the vagina is collected, processed and stained. No cervical cancer screening recommended 65 years old if they have had prior adequate screening negative cytology alone or negative cytology and hpv as last pap smear even if a women has a new sexual partner after age 65, she does not need to be rescreened if above criteria are met.
These services are reported under codes g0124, g0141, or p3001. The textual nature of these reports doesnt fit well into the emr flowsheet model where a cell only shows the first 810 characters of a result yet the rigidly defined format of the centricity lab report doesnt lend itself to. The current reporting system is the bethesda system, which was introduced in 19886 and later updated again in 1999 table 1. The papanicolaou pap test is one screening strategy used to prevent cervical cancer in developed countries. Its primary purpose is to identify patients who have cellular changes that place them at risk for the development of cervical cancer. Uniform guidelines for cervical cancer screening in flanders. A pap smear, also called a pap test, is a procedure to test for cervical cancer in women. Hpv testing should not be used in this age group unless its needed after an abnormal pap test result.
For a cervical or vaginal smear test pap smear, the social security act section 1833h7 requires payment to be t he lesser of the local fee or the nla, but not less than a national minimum payment amount described below. Sexual activity includes intercourse, as well as digital or oral. This presentation provides a summary of the pap test as a test for the detection of cervical cancer. Nov 27, 20 accuracy single pap smeardiagnostic sensitivity 60% false negative results upto25% due to. Reflex testing hpv low and high risk hpv high risk only. Jul 19, 2019 most women with abnormal cervical cancer screening results do not have cancer. Excessive use of lubricating jelly on the vaginal speculum will interfere with cytologic examination and may lead to unsatisfactory pap results. Predictive value of p16ki67 immunocytochemistry for. Cytopathology cytopathology i gynecologic cytopathology pre. Screening pap smears effective 112017, hmsas commercial plans include laboratory benefits for one routine screening pap smear every 3 calendar years for women beginning at age 21 years old through age 65 years old. This policy also applies to screening pap smears requiring a physician interpretation. Hpv is a sexually transmitted infection that goes away on its own in most people. Pap smears are a screening tool that may require repeating. Pap smear test for cervical cancer under the microscope.
Infection by highrisk hpv types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 may be associated with precancerous lesions or cancer of the cervix. Since contamination is common in the smear zone and often is the most concentrated in that area, definition of smear zone contamination is clearly required by chapter nr 716, wis. This policy documents rhode island general law rigl 272017, mammograms and pap smears. A pap test, also called a pap smear, is an exam a doctor uses to test for cervical cancer in women. Pap smears can be abnormal if the cervix is inflamed or irritated. The p16ki67 immunocytochemistry is a triage test performed on pap smears in women with atypical squamous cells of undetermined significance ascus or low grade squamous intraepithelial lesion. Pap smears brush and scrape off loose cells for microscopic evaluation. To create this article, volunteer authors worked to edit and improve it over time.
A pap smear can detect hpv, a virus that causes cervical cancer. A pap smear is a simple, quick, and relatively painless. However, for a cervical or vaginal smear test pap smear, payment may also not exceed the actual charge. Definisi pap smear pdf definisi pap smear pap test adalah pemeriksaan sitologik epitel porsio dan endoserviks uteri untuk penentuan adanya perubahan praganas maupun ganas di. Ehr gpra cervical cancer screening pap smear keywords.
Evaluation and treatment the cervix is the lower part of the uterus that protrudes into the vagina. An abnormal pap smear result means that some of the cells of the cervix look different from the normal cells. Detecting cervical cancer early with a pap smear gives you a greater chance at a cure. The conventional pap smear test was used for cytology. Uconnect cytopathology services and uw health cytopathology services pages include video instructions on pap collection. Women 30 years of age and older who have had normal pap smears 3 years in a row may have a pap smear every 23 years. Introduction, principle, procedure and interpretation. Clear, readable, illustrated booklet summarising the conclusions of the three working groups. Vaginal smear for hormonal evaluation, obtain cells from the upper third of the lateral vaginal wall. Every 5 years pap and cotesting is acceptable for low risk women low risk confirmed 10 year ho of normal paps and at least one negative hpv test. Understanding abnormal cervical cancer screening results. Most information and illustrations in this book are extracted from the authors. Dysplasia means the cells on the pap smear look abnormal under a microscope. A pap test is a screening test that can also be a diagnostic test.
Pap test results pap tests, pap smears, hpv, cervical cancer. Pap smears are recommended for all women starting at age 21, or 3 years after they start having sex whichever comes first. Include date of birth, social security number or other identification number, previous malignancy, drug therapy, radiation therapy, last menstrual period lmp, postmenopausal patient pmp, surgery including surgical biopsies, exogenous hormones, abnormal vaginal bleeding, abnormal pap results, iud, and all other pertinent clinical information on the cytology test request form. Not all problems need treatment, and those that do can be treated quite easily and usually very successfully. Liquidbased, thinlayer preparation of cervical cytology specimens was a subsequent modification in technique. Pap tests are not designed to detect infections or to detect cancer of the ovaries or uterus. After hysterectomy for benign causes, women need not undergo routine pap smears unless symptomatic, history of sil, or has associated risk factors as above. Precancers are cell changes that can be caused by the human papillomavirus hpv. Pap and hpv tests pap tests or pap smears look for cancers and precancers in the cervix. It may be recommended to do pap smears more often in. Boston medical center maternity care guideline guideline.
Pap smear test procedure, results interpretation health. Ask your doctor, nurse or health worker to explain exactly what type of abnormality has been detected or is suspected on your pap smear. Manish kumar assistant professor, pathology, kpc medical college, jadavpur, kolkata, india article info abstract papanicolaou screening is the standard of care for detection of abnormal cervical cell. Mortality files, national center for health statistics, cdc. A pap smear test usually takes a minute or two to be performed and is usually conducted in the doctors office. Women with positive hpv types 1618 and a normal pap smear have an 18 to 21 percent 10year risk of developing cin3, hpv genotyping test may prove useful, compared to women with non.
This program offered a free pap test every two years to women between the ages of 18 and 70. Most women can stop having pap tests at the age of 70. Not all problems need treatment, and those that do. Health pap smears, including how corrected reports are issued as well as how to document correlation cases and qa monitors.
Gynecologic pap smear, one slide, two slides labcorp. Ppap smear reportingap smear reporting the pap smear reporting classification has evolved and been refined over time. Cancer of the cervix cervical cancer is the fourth most common cause of cancer related death among women worldwide. Cervical cytology became the standard screening test for cervical cancer and premalignant cervical lesions with the introduction of the papanicolaou pap smear in 1941. This monograph essentials of pap smear and breast cytology is prepared at the request of a large number of students in cytology who wish to have a small and concise book with numerous illustrations for easy reference during their laboratory training. Women between the ages of 30 and 65 should have a pap test plus an hpv human papillomavirus test called cotesting done every 5 years. Gyenocologic pap test collection procedure medical center. Carriers often deny these claims because coders misapply one of four physician pap interpretation codes. Screening recommended every 3 years for women 2129. The human papillomavirus hpv test and the pap test examine cells from a womans cervix. Understand medical legal issues relating to pap smears, including importance of high qualitypreparations, adequacy of smears, accurate interpretation and timely reporting and followup. Pap smear adalah ilmu yang mempelajari selsel yang lepas dari sistem alat kandungan wanita lestadi, 2009. Women typically are advised to start getting pap tests around age 21.
Cervical cancer incidence and mortality rates have halved in australia since the introduction of the national cervical screening program in 1991. Introduction, principle, procedure and interpretation by editorial team on january 12, 2020 in cytopathology papanicolaou stain also papanicolaous stain or pap stain is the most important stain utilized in the practice of cytopathology. Pap smear for the identification of ascending grades of cervical intraepithelial neoplasia cin developing into. It can also reveal changes in your cervical cells that may turn into cancer later.