Management of Abnormal Cytology
Introduction: This chapter will discuss the indications and management of abnormal cervical cytology. This chapter draws on guidelines from the USA, the UK, Canada and Europe.
Article: Cancer of the uterine cervix is the most common gynaecological malignancy worldwide, and effective screening has been shown to reduce its incidence and prevalence. The scope of cervical cytological results is discussed with management indications, contraindications and exceptions. The cytological management depends on the triaging of patients into either low-risk or high-risk groups, indicating return to routine screening or a referral for diagnostics. The colposcopic management of such results will be discussed in a later chapter.
Summary: Cervical cytology has been proven to be a very useful test to detect and triage patients with preinvasive conditions. Many regions and/or countries have local guidelines, but there are similarities and a general consensus in management. Primary HPV screening has proven to be effective and in some regions will replace primary cytological screening.
KeywordsCervical cytology Borderline Low-grade High-grade dyskaryosis Atypical squamous cells Low-grade squamous intraepithelial lesion (LSIL) High-grade squamous intraepithelial lesion (HSIL) Glandular (1) HPV (human papillomavirus) Pregnancy Carcinoma in situ neoplasia (CIN) Cancer
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