Cervical screening
[1][2] One goal of cervical screening is to allow for intervention and treatment so abnormal lesions can be removed prior to progression to cancer.
Visual Inspection tests involve application of a solution to enhance identification of abnormal areas and can utilize the naked eye or a colposcope/magnifying camera.
The World Health Organization has also published guidelines to increase screening and improve outcomes for all women taking into consideration differences in resource availability of regions.
Management of abnormal screening results can include surveillance, biopsy, or removal of the suspicious region via surgical intervention.
[4] To take the sample of cells, the health care clinician inserts an instrument, called a speculum, inside the vagina.
[7] The screening process utilizes nucleic acid amplification testing to look for DNA or RNA of the virus present within cervical cells.
Accuracy of liquid based monolayer cytology report:[10] Visual inspection involves the application of ascetic acid or lugol's iodine solution to the cervix.
[11] These results can be utilized to calculate the patient's immediate risk for cervical intraepithelial neoplasia grade 3 or cancer (CIN3+).
[citation needed] Different countries and medical organizations have specific cervical screening recommendations to guide patient care.
[15] In the United states the U.S. Preventative Service Task Force (USPSTF) is an independent entity that periodically assesses and alters screening guidelines.
[21] Management of screening results is based on recommendations by the American College of Obstetricians and Gynecologists and other professional organizations.
"[25] The Ministry of Public Health recommends women from age 30-60 receive primary HPV testing every 5 years.
Women who receive an abnormal test result will be guided on their next recommended steps by their healthcare provider.
Some of the follow-up options include surveillance, histological diagnosis via colposcopy/biopsy, or removal of the abnormal tissue via an ablative or surgical method.
[27] The Bill and Melinda Gates Foundation has funded an eight-year study of a DNA test for the virus that causes cervical cancer.
This may improve the chances of early diagnosis for women who are unwilling to be screened due to discomfort or modesty.
[28] VIA, one of the alternative approaches to conventional testing, has shown to have a low specificity compared to cytology and a high rate of false positives in several studies.
Between community centers high variability has been observed, and even in a study of Nigeria of 2013 VIA was not reproducible nor sensitive; this led to discouraging the method in that country.
