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Health Condition

Abnormal Pap Smear

About This Condition

Sexually active teenagers and women 20 to 65 years old are advised to have periodic Pap smears, where a small amount of tissue is swabbed from the cervix and examined for evidence of precancerous or cancerous changes. A pap smear is considered abnormal when abnormal cervical cells are found. Cervical dysplasia is a term used to describe abnormal cervical cells taken during the pap smear. Cervical dysplasia is usually graded according to its severity, which can range from mild inflammation to precancerous changes to localized cancer.

If an abnormality is detected early, the doctor can prescribe effective treatment before the problem becomes more serious. Cervical cancer is a common, sometimes fatal disease. It is now known that human papilloma virus (HPV), also the cause of genital warts, is the major cause of cervical dysplasia.

Symptoms

There are no symptoms of cervical dysplasia until the disease has progressed into advanced cancer. Therefore, it is crucial that sexually active women, or women over age 20, have yearly Pap smears until the age of 65. Women who experience bleeding between menstrual periods, bleeding after intercourse, abnormal vaginal discharge, abdominal pain or swelling, urinary symptoms, or pelvic pain should be evaluated by a healthcare provider, even if it is not the regular time for a Pap test.

Other Therapies

If the Pap smear is normal, no further tests are necessary until the next yearly Pap test. If the cells collected on the Pap smear are abnormal, a repeat test and a pelvic exam where the doctor looks at the cervix with a special magnifying lens (colposcope) may be recommended. Sometimes a small piece of tissue is removed from the cervix (biopsy) and examined under a microscope to see if there are any precancerous changes or cancer present. If these additional tests find an early stage of cervical cancer, it is either treated by removing the affected portion of the cervix (cone biopsy) or by removing the entire cervix and uterus (abdominal hysterectomy).

References

1. Butterworth CE Jr, Hatch KD, Gore H, et al. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982;35:73-82.

2. Zarcone R, Bellini P, Carfora E, et al. Folic acid and cervix dysplasia. Minerva Ginecol 1996;48:397-400.

3. Butterworth CE, Hatch KD, Soong S-J, et al. Oral folic acid supplementation for cervical dysplasia: A clinical intervention trial. Am J Obstet Gynecol 1992;166:803-9.

4. Butterworth CE Jr, Hatch KD, Macaluso M, et al. Folate deficiency and cervical dysplasia. JAMA 1992;267:528-33.

5. Piyathilake CJ, Macaluso M, Brill I, et al. Lower red blood cell folate enhances the HPV-16-associated risk of cervical intraepithelial neoplasia. Nutrition 2007;23:203-10.

6. Ahn WS, Yoo J, Huh SW, et al. Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions. Eur J Cancer Prev 2003;12:383-90.

7. Hudson T. Women's Encyclopedia of Natural Medicine. Lincolnwood, IL: Keats, 1999, 54.

8. Dawson EB, Nosovitch JT, Hannigan EV. Serum vitamin and selenium changes in cervical dysplasia. Fed Proc 1984;43:612.

9. Wassertheil-Smoller S, Romney SL, Wylie-Rosett J, et al. Dietary vitamin C and uterine cervical dysplasia. Am J Epidemiol 1981;114:714-24.

10. Ho GY, Palan PR, Basu J, et al. Viral characteristics of human papillomavirus infection and antioxidant levels as risk factors for cervical dysplasia. Int J Cancer 1998;78:594-9.

11. Romney SL, Palan PR, Duttagupta C, et al. Retinoids and the prevention of cervical dysplasias. Am J Obstet Gynecol 1981;141:890-4.

12. Palan PR, Mikhail MS, Basu J, Romney SL. Plasma levels of antioxidant beta-carotene and alpha-tocopherol in uterine cervix dysplasias and cancer. Nutr Cancer l991;15:13-20.

13. Ho GY, Palan PR, Basu J, et al. Viral characteristics of human papillomavirus infection and antioxidant levels as risk factors for cervical dysplasia. Int J Cancer 1998;78:594-9.

14. Kwasniewska A, Charzewska J, Tukendorf A, Semczuk M. Dietary factors in women with dysplasia colli uteri associated with human papillomavirus infection. Nutr Cancer 1998;30:39-45.

15. Romney SL, Palan PR, Basu J, Mikhail M. Nutrient antioxidants in the pathogenesis and prevention of cervical dysplasias and cancer. J Cell Biochem Suppl 1995;23:96-103 [review].

16. Ziegler RG, Jones CJ, Brinton LA, et al. Diet and the risk of in situ cervical cancer among white women in the United States. Cancer Causes Control 1991;2:17-29.

17. Kantesky PA, Gammon MD, Mandelblatt J, et al. Dietary intake and blood levels of lycopene: association with cervical dysplasia among non-Hispanic, black women. Nutr Cancer 1998;31:31-40.

18. VanEenwyk J, Davis FG, Bowen PE. Dietary and serum carotenoids and cervical intraepithelial neoplasia. Int J Cancer 1991;48:34-8.

19. de Vet HC, Sturmans F. Risk factors for cervical dysplasia: implications for prevention. Public Health 1994;108:241-9.

20. Becker TM, Wheeler CM, McGough NS, et al. Cigarette smoking and other risk factors for cervical dysplasia in southwestern Hispanic and non-Hispanic white women. Cancer Epidemiol Biomarkers Prev 1994;3:113-9.

21. Kanetsky PA, Gammon MD, Mandelblatt J, et al. Cigarette smoking and cervical dysplasia among non-Hispanic black women. Cancer Detect Prev 1998;22:109-19.

22. Daly SF, Doyle M, English J, et al. Can the number of cigarettes smoked predict high-grade cervical intraepithelial neoplasia among women with mildly abnormal cervical smears? Am J Obstet Gynecol 1998;179:399-402.

23. Cerqueira EM, Santoro CL, Donozo NF, et al. Genetic damage in exfoliated cells of the uterine cervix. Association and interaction between cigarette smoking and progression to malignant transformation? Acta Cytol 1998;42:639-49.

24. Brinton LA. Epidemiology of cervical cancer—overview. In Munoz N, Bosch FX, Shah KV, Meheus A, eds. The epidemiology of cervical cancer and human papillomavirus. Lyon, France: IARC, 1992, 3-23.

25. Parazzini F, Negri E, La Vecchia C, Fedele L. Barrier methods of contraception and the risk of cervical neoplasia. Contraception 1989;40:519-30.

26. Coker AL, Hulka BS, McCann MF, Walton LA. Barrier methods of contraception and cervical intraepithelial neoplasia. Contraception 1992;45:1-10.

27. Becker TM, Wheeler CM, McGough NS, et al. Contraceptive and reproductive risks for cervical dysplasia in southwestern Hispanic and non-Hispanic white women. Int J Epidemiol 1994;23:913-22.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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