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Abnormal Pap Test
- 1. Management of Women with Abnormal Pap Test
- 4. Comparison of Terminology Bethesda System CIN system Dysplasia ASCUS Cellular Atypia Unspecified Cellular changes LSIL CIN I Mild Dysplasia HSIL CIN II Moderate dysplasia CIN III Severe Dysplasia/ CIS
- 6. Abnormal Pap test ASCUS LSIL HSIL HPV –ve HPV +ve Rpt Pap Negative Colposcopy LEEP ECC +ve -ve Treat & Follow up Diagnostic cone Treat & Follow up
- 11. Rpt Cytology @ 6 & 12 Months HPV –ve HPV +ve Rpt Cytology @ 12 months Colposcopy ECC if no lesions or unsatisfactory colpo No CIN CIN Repeat Cytology @ 6, 12 months Or HPV DNA test @12 months Treat & follow up ASCUS
- 14. ASC-H Colposcopy ECC if no lesions or unsatisfactory colpo CIN 2,3 > ASC or HPV+ Treat & Follow up Rpt Cytology @ 6, 12 months OR HPV DNA Test @ 12 mths No CIN 2,3 Colposcopy Negative Routine screening
- 15. Low Grade SIL
- 18. LSIL Colposcopy Negative Unsatisfactory colpo No lesion Satisfactory Colpo Lesion in TZ ECC No CIN CIN 2,3 Cytology @ 6, 12 mths OR HPV testing Treat & Follow up
- 20. HIGH GRADE SIL HSIL
- 22. HSIL Colposcopy ECC Unsatisfactory colpo Satisfactory Colpo No CIN 2,3 Diagnostic Excisional procedure Observe with Cytology / Colposcopy Treat & Follow up LEEP CIN 2,3
- 32. AIS Hysterectomy preferred Margins involved ECC +ve Reexcision recommended Long term Follow up Diagnostic excisional procedure If future fertility desired Conservative Management Margins negative