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文檔簡介
Understanding
CervicalChanges
AHealthGuide
U.S.DepartmentofHealth&HumanServices|NationalInstitutesofHealth
“Thisbooklethelpedme
talkwithmydoctor
afteranabnormal
testresult.”
“Mydoctorexplainedthatcervicalcancerscreeningtestscanfind
changesincervicalcellsthatarenotcancerandcanbetreated.
Thiswasreassuringtoknow.”
“Nowthatmychildis11,
mydaughter’sdoctorsaid
sheisdueforvaccinations
tohelpprotectherfrom
meningitis,whoopingcough,
andHPV-relatedcancers.”
Healthcareproviders:Here’sahandoutthatcanhelpyourpatientsaccessanonlineversionof
thisbooklet:
/ucc-flyer
.
TableofContents
Usethisguidetolearnmoreandtalkwith
Introductionii
yourhealthcareproviderabout:
HPVInfection1
CervicalCancerScreening2
ScreeningGuidelines:WhentoGetScreened4
HPVTestResults6
PapTestResults7
Follow-upTestsandProcedures9
TreatmentsforHigh-GradeCervicalCellChanges12
HPVVaccination14
RelatedResources15
hamg
Guidelimes
i
Introduction
Youmaybereadingthisbookletbecauseyouhadanabnormalcervicalcancer
screeningtest.Althoughit’scommontofeeluneasy,youshouldknowthatmost
womenwhohaveabnormalcervicalscreeningtestresultsdonothavecervicalcancer.Mosthaveearlycellchangesthatcanbemonitored(sincetheyoftengoawayontheirown)ortreatedearly(topreventproblemslater).So,getthefollow-upvisits,tests,ortreatmentthatyourhealthcareprovideradvises.
Scientificadvanceshavehelpeduslearnmuchmoreabouthowcervicalcancer
develops,aswellashowandwhentoscreenwomen.However,theseadvanceshavealsoaddedalayerofcomplexityforhealthcareprovidersandwomen.Thisbooklet
helpsyoutalkwithyourhealthcareproviderandmakeinformeddecisionstopreventcervicalcancer.
Goodnewsabout
preventingcervicalcancer
Weknowwhatcausescervicalcancer.
Nearlyallcervicalcanceriscausedbyaviruscalled
HPV
(humanpapillomavirus).
Cervicalcellchangeshappenslowly.
ItcantakemanyyearsforcellsinfectedwithHPVtodevelopinto
cervicalcancer.
Wehavegreattoolstopreventcervicalcancer.
Cervicalcancer
screening
and
HPVvaccination
canpreventcervicalcancer.
Betterscreeningtestsmeanlessfrequentscreening.
Becauseofimprovementsincervicalcancerscreening,guidelinesnowrecommendlessfrequentscreeningthanbefore.
Abnormaltestresultsdon’tmeanthatyouhavecancer.
Anabnormalcervicalscreeningtestresultdoesnotmeanthatyouhavecervicalcancer.ItmeansthatcervicalcellchangeswerefoundorthatcellsareinfectedwithHPV.
Dependingontheresults,youmayneedfollow-uptestingortreatment.Treatmentforcervicalcellchangesworkswell.
ii
HPVInfection
“Mydoctortoldmethatlong-lasting
infectionswithcertainHPVtypescan
causecancerinthecervix,vagina,
andvulva,aswellasintheanus,
penis,andpartsofthemouth.”
Humanpapillomavirus(HPV)andcervicalcellchanges
HPVsareagroupofrelatedviruses,someofwhicharespreadthroughsexualcontactandcancausecancer,includingcervicalcancer.HerearesomebasicfactsaboutHPV:
Therearemanytypesofsexuallytransmittedhumanpapillomaviruses(HPVs).
●
High-riskHPV
typescaninfectcervicalcellsandcause
cervicalcancer
.Theycanalso
infectcertainothercellstocauseanalcancer,penilecancer,vaginalcancer,vulvarcancer,andoropharyngealcancer(cancerinthemiddleofthethroat,includingthetonsilsandthebackofthetongue).
●
Low-riskHPV
typescancause
genitalwarts
.Thesearewartsontheexternalandinternalsexorgansandglands.Genitalwartsdonotturnintocancer.
SmokingmayincreasetheriskthatanHPVinfectionwillpersistanddevelopintocervicalcancer.SoifyousmokeandhaveanabnormalPaporHPVtestresult,itisespecially
importanttostopsmoking.
HPVinfectionsarecommon.MostpeoplewhoaresexuallyactivewillhaveanHPV
infectionatsomepointandneverknowit.HPVinfectionscanbespreadthroughskin-to-skincontact,includingvaginal,anal,andoralsex.Althoughcondomscanlowertheriskofan
HPVinfection,theydonotprotectagainstthemcompletely.
MostHPVinfections,evenwithhigh-risktypes,goawayontheirownwithoutcausingproblems.Theyarefoughtoffbythebody’s
immunesystem
.However,sometimesinfectionswith
high-riskHPV
typesdonotgoaway.Whenahigh-riskHPVinfectionof
cervicalcellslastsmanyyears,thecellscanbecomeabnormal.Thesechangescangetworse
overtimeandmaybecomecervicalcancer.Althoughthereiscurrentlynowaytotreatan
HPVinfection,cervicalcancercanbepreventedbydetectingandremovingabnormalcervicalcellsbeforetheybecomecancer.
FormoreinformationaboutHPVandcancer,visit:
/hpv
.
1
CervicalCancerScreening
“Cervicalcancerscreeningcanfind
abnormalcellchangesthatcanbe
monitoredortreatedearly,before
theydevelopintocervicalcancer.”
Screeningtestsforcervicalcancer
Screeningtestsareusedtocheckfordiseasewhentherearenosymptoms.Thegoalofscreeningforcervicalcanceristofindcellchangesatanearlystagebeforetheybecomecancerandwhentreatmentcanpreventcancerfromdeveloping.
The
HPVtest
checkscellsforinfectionwithhigh-riskHPVtypesthatcancausecancer.
The
Paptest
(alsocalleda
Papsmear
orcervical
cytology
)collectscervicalcellsandlooksatthemforchangescausedbyHPVthatmay—ifleftuntreated—turnintocervicalcancer.Itcanalsodetectcervicalcancercells.APaptestsometimesfindsconditionsthatarenotcancer,
suchasinfectionorinflammation.
The
HPV/Papcotest
usesaPaptestandHPVtesttogethertocheckforbothhigh-riskHPVandcervicalcellchanges.
Wheretogetscreened
Doctors’offices,clinics,andcommunityhealthcentersofferHPVandPaptests.Manywomenreceivethesetestsfromtheir
ob/gyn
(obstetrics/gynecology)orprimarycareprovider.Ifyoudon’thaveaprimarycareprovider,ordoctoryouseeregularly,youcanfindaclinicnearyouthatofferscervicalcancerscreeningbycontacting:
●Yourstateorlocalhealthdepartment.
●TheNationalBreastandCervicalCancerEarlyDetectionProgram(NBCCEDP)bycalling1-800-232-4636orvisiting
.NBCCEDPisaserviceoftheCDCthatprovideslow-income,uninsured,andunderservedwomenaccesstocervicalcancerscreeninganddiagnosticservices.
●APlannedParenthoodclinicbycalling1-800-230-7526orvisiting:
.
●NCI’sCancerInformationService(CIS)bycalling1-800-422-6237orvisiting:
/contact
.
2
Whattoexpect
Cervicalcancerscreeningisusuallydoneduring
a
pelvicexam
,whichtakesonlyafewminutes.
Duringthisexam,youlieonyourbackonan
examtable,bendyourknees,andputyourfeet
intosupportsattheendofthetable.Thehealth
careproviderusesa
speculum
togentlyopenyour
vagina
inordertoseethe
cervix
.Asoft,narrow
brushortinyspatulaisusedtocollectasmallsampleofcellsfromyourcervix.
Thesampleofcervicalcellsissenttothelabandcheckedforabnormalcervicalcells.Thesame
samplecanalsobecheckedforHPV,withanHPVtest.WhenbothaPaptestandanHPVtestare
done,thisiscalled
HPV/Papcotest
.
Apelvicexammayincludemorethantaking
samplesforanHPVand/orPaptest.Yourhealthcareprovidermayalsocheckthesize,shape,andpositionoftheuterusandovariesandfeelforanylumpsorcysts.The
rectum
mayalsobecheckedforlumpsorabnormalareas.Mosthealthcare
providerswilltellyouwhattoexpectateachstepoftheexam,soyouwillbeatease.Youmayalsoasktobetestedforother
sexuallytransmitted
infections(STIs)
.
Questionstoask
Beforeyourexam
Askyourhealthcareprovider:
●Whatwillhappenduringtheexam?
●WhattestswillIhave?
●Whatisthepurposeofthesetests?
●WillIhaveanydiscomfort?
Yourhealthcareprovider
mayaskyou:
●Whatwasthestartdateofyourlastmenstrualperiod?
●Whendidyouhaveyourlast
cervicalcancerscreeningtest?
●Whatwereyourtestresults?
●Haveyoueverhadabnormaltestresults?
●Haveyoueverhadtreatmentforabnormalcellsonyourcervix?
Afteryourexam
Askyourhealthcareprovider:
●WhenwillIgetmytestresults?
●HowwillIgettheseresults
(e.g.,bymail,online,orphonecall)?
●WhatphonenumbershouldIcallifIdonotgetmytestresults?
●WhenIgetmyresults,willtheyexplainwhatIshoulddonext?
Thefemale
reproductivesystem
Thecervixispartofthefemalereproductivesystem.It’sthe
lower,narrowendoftheuterus,whichleadstothevagina.Thecervixopensduringchildbirthtoallowthebabytopass
through.
3
ScreeningGuidelines:
WhentoGetScreened
“Talkwithyourfamilyandfriends
aboutscreeningforcervicalcancer.
Over4,000womenintheUnited
Statesdieofcervicalcancerevery
year.Cervicalcanceriseasyto
preventwithroutinescreening.”
Cervicalcancerscreeningrecommendationshavebeendevelopedbyorganizations,
includingtheUnitedStatesPreventiveServicesTaskForce(USPSTF)andtheAmerican
CancerSociety.Whilethedetailsoftherecommendationsvary,theyarebasedonresearchfindingssuchas:
●HPV-causedchangesincervicalcellshappenslowlyandoftengoawayontheirown,especiallyinyoungerwomen
●moreeffectivescreeningtests
●theharmsofovertestingandovertreatmentforcervicalcellchangesthatwouldhavegoneawayontheirown
Cervicalcancerscreeningguidelinesformostwomen
Talkwithyourhealthcareprovideraboutwhentostartscreening,howoftentobe
screened,andwhatscreeningtesttohave.Theseagesandtimesbetweenscreeningsapplytomostwomen,aslongastheyhavenormaltestresults.Exceptionstothesescreening
recommendationsarenotedintheboxonpage5.
“Getafreeorlow-costcervicalcancer
screeningtest.It’savailableifyoudon’thavehealthinsuranceorhavealowincome.Goto
/cancer/nbccedp
tolearnmore
andfindascreeningprogramnearyou.”
4
Talkwithyourhealthcareprovideraboutwhetheryouneedapersonalizedscreeningplan.
Certainhealthconditions
Morefrequentscreeningmayberecommendedifyou:
●are
HIVpositive
●haveaweakened
immunesystem
●wereexposedbeforebirthtoamedicinecalled
diethylstilbestrol(DES)
,whichwasprescribedtosomepregnantwomen
throughthemid-1970s
●hadarecentabnormalcervicalscreeningtestor
biopsy
result
●havehad
cervicalcancer
Hysterectomy
Screeningrecommendationsarebasedonyourpersonalmedicalhistory,includingthetypeofhysterectomyyoumayhavehad:
●
Partialhysterectomy
or
supracervical
hysterectomy
:Ifyouhadanoperationtoremoveyouruterusbutnotyourcervix,youshouldcontinueroutinecervical
cancerscreening.
●
Totalhysterectomy
:Ifyouhadanoperationtoremovebothyouruterusandcervixforreasonsnotrelatedtocancerorabnormalcervicalcells,youdonotneedtobe
screenedforcervicalcancer.
●
Hysterectomy
:Ifyouhadanytypeof
hysterectomyrelatedtocervicalcanceror
precancer
,talkwithyourhealthcareprovidertolearnwhatfollow-upcare
youneed,basedonyourspecific
medicalhistory.
Age21-29years
GetyourfirstPaptestatage21andhavePaptestingevery3years.Evenifyouarealreadysexuallyactive,
Paptestsarenotrecommended
untilage21,accordingtoUSPSTF
recommendations.
Age30-65years
GetanHPVtestevery5years,anHPV/Papcotestevery5years,oraPaptestevery3years,accordingtoUSPSTFrecommendations.
TheAmericanCancerSociety
recommendsHPVtestsevery5years,startingatage25.ScreeningwithanHPV/Papcotestevery5yearsoraPaptestevery3yearsisalsoacceptable.
Olderthan65years
Ifyouareinthisagegroupyou
shouldtalkwithyourhealthcare
providertolearnifscreeningisstill
needed.Ifyouhavebeenscreened
regularlyandhadnormaltestresults,yourhealthcareproviderwillprobablyadvisethatyounolongerneed
screening.However,ifyourrecent
testresultswereabnormaloryou
havenotbeenscreenedregularly,
youneedtocontinuescreening
beyondage65.
Formoreinformationaboutscreening
guidelines,visit:
/ucc
.
Exceptionstotheguidelines
5
HPVTestResults
HPVtest
resultsshowifhigh-riskHPVtypeswerefoundincervicalcells.AnHPVtestwillcomebackasa
positivetestresult
ora
negativetestresult
:
●PositiveHPVtestresult:High-riskHPVwasfound.Yourhealthcareproviderwillrecommendfollow-upstepsyouneedtotakebasedonyourspecifictestresult,suchasthoselistedintheFollow-upTestsandProceduressectionon
page9
.
●NegativeHPVtestresult:High-riskHPVwasnotfound.Youneedtobetestedagainin5years.However,yourhealthcareprovidermayadviseyoutocomebacksoonerifyouhadabnormalresultsinthepast.
HPVtestresultsusuallycomebackfromthelabinabout1–3weeks.Ifyoudon’thearfromyourhealthcareprovider,callandaskforyourtestresults.Makesureyougetanyfollow-uptestsorproceduresthatarerecommended.
WhatdoesitmeanifIhaveapositiveHPVtestafteryearsofnegativetests?
Sometimes,afterseveralnegativeHPVtests,youmayhaveapositiveHPVtestresult.Ifyouhaveanewsexualpartner,thisismostlikelyanewinfection.Ifyoudonothaveasexual
partner,orifyouareina
monogamous
relationship,thisisnotnecessarilyasignofanewHPVinfection,anditdoesn’tmeanthatyourpartnerhasanewsexualpartner.Sometimes
anHPVinfectioncanbecomeactiveagainaftermanyyears.Someothervirusesbehavethiswayaswell;forexample,thevirusthatcauses
chickenpox
canreactivatelaterinlifetocause
shingles
.
ThereisnowaytotellwhetheranewlypositiveHPVtestresultisasignofanewinfectionora
reactivation
ofanoldinfection.Researchersdon’tknowwhetherareactivatedHPVinfectionhasthesameriskofcausingcervicalcellchangesorcervicalcancerasanewHPVinfection.
“IhelpmypatientsunderstandwhattheirHPVtestresultmeans,and
whatmonitoringorfollow-upcareisneeded.”
6
PapTestResults
Paptestresultsshowifcervicalcellsarenormalorabnormal.APaptestmayalsocomebackasunsatisfactory.
●NormalPaptestresult:AnormalPaptestresultmayalsobecalleda
negativetest
result
or
negativeforintraepitheliallesionormalignancy(NILM)
.IfonlythePaptestwasdone,youshouldhaveanotherPaptestin3years.IfthePaptestwasdonetogetherwithanHPVtest(thisiscalleda
Pap/HPVcotest
),youshouldhavethistestagainin5years.Youmayneedtocomebacksoonerifyouhavehadabnormalresultsinthepast..
●AbnormalPaptestresult:Anabnormaltestresultmayalsobecalleda
positivetest
result
.AnabnormalPaptestresultdoesnotmeanyouhavecervicalcancer.Possible
abnormalfindingsonaPaptestinclude
ASC-US
,
AGC
,
LSIL
,
ASC-H
,
HSIL
,
AIS
,or
cervicalcancer
.Yourhealthcareproviderwillrecommendfollow-upstepsyouneedtotakebasedonyourspecifictestresultandyourpasttestresults.
●UnsatisfactoryPaptestresult:Thelabsamplemaynothavehadenoughcells,orthecellsmayhavebeenclumpedtogetherorhiddenbybloodor
mucus
.Yourhealthcare
providerwillusuallyaskyoutocomeinforanotherscreeningtestin2to4months.
Paptestresultsusuallycomebackfromthelabinabout1–3weeks.Ifyoudon’thearfromyourhealthcareprovider,callandaskforyourtestresults.Makesureyoureceiveyourtestresultsandunderstandanyfollow-upvisitsortreatmentsthatyouneed.
Cervicalcellchanges
Theseimagesshowhowcervicalcellsthathavelong-lastinginfectionswithhigh-riskHPVcanchangeovertimeandbecomeabnormal.Abnormalcervicalcellsmayalsoreturnto
normalevenwithouttreatment,especiallyinyoungerwomen.LSILandHSILaretwotypesofabnormalchangestocervicalsquamouscells.
7
Paptestresultsandpossiblenextsteps
ASC-US
Atypical
SquamousCellsofUndetermined
Significance
AtypicalSquamousCellsofUndeterminedSignificance(
ASC-US
)isthemost
commonabnormalPaptestfinding.Itmeanssomecellsdon’tlookcompletely
normal,butit’snotclearifthechangesarecausedbyHPVinfection.Otherthingscancausecellstolookabnormal,includingirritation,some
infections
(such
asa
yeastinfection
),growths(suchas
polyps
intheuterus),andchangesin
hormones
thatoccurduringpregnancyor
menopause
.Althoughthesethings
maymakecervicalcellslookabnormal,theyarenotrelatedtocancer.YourhealthcareproviderwillusuallydoanHPVtesttoseeifthechangesmaybecausedbyanHPVinfection.IftheHPVtestisnegative,
estrogencream
maybeprescribedtoseeifthecellchangesarecausedbylowhormonelevels.IftheHPVtestispositive,youmayneedadditionalfollow-uptestsasexplainedon
page9
.
AGC
AtypicalGlandularCells
AtypicalGlandularCells(
AGC
)meanssomeglandularcellswerefoundthatdonotlooknormal.Thiscanbeasignofamoreseriousproblemupinsidetheuterus,soyourhealthcareproviderwilllikelyaskyoutocomebackfora
colposcopy
,asexplainedon
page10
.
LSIL
Low-Grade
Squamous
Intraepithelial
Lesions
Low-GradeSquamousIntraepithelialLesions
(LSIL
)meansthereare
low-grade
changesthatareusuallycausedbyanHPVinfection.Yourhealthcareproviderwilllikelyaskyoutocomebackformoretesting,asexplainedon
page10
,tomake
surethattherearenotmoreserious(
high-grade
)changes.
ASC-H
AtypicalSquamousCells,Cannot
ExcludeHSIL
AtypicalSquamousCells,cannotexcludeHSIL(
ASC-H
)meanssomeabnormal
squamouscellswerefoundthatmaybeahigh-gradesquamousintraepitheliallesion(
HSIL
),althoughit’snotcertain.Yourhealthcareproviderwilllikelyaskyouto
comebackforacolposcopy,asexplainedon
page10
.
HSIL
High-Grade
Squamous
Intraepithelial
Lesions
High-GradeSquamousIntraepithelialLesions(
HSIL
)meanstherearemoderatelyorseverelyabnormalcervicalcellsthatcouldbecomecancerinthefutureifnot
treated.Somelesionsmaybecalled
precancer
.Yourhealthcareproviderwilllikelyaskyoutocomebackforacolposcopy,asexplainedon
page10
.
AIS
AdenocarcinomaInSitu
Adenocarcinomainsitu(
AIS
)meansanadvanced
lesion
(areaofabnormaltissue)wasfoundintheglandulartissueofthecervix.AISlesionsmaybecomecancer
(
cervicaladenocarcinoma
)ifnottreated.Yourhealthcareproviderwilllikelyaskyoutocomebackforacolposcopyand
biopsy
,asexplainedon
page10
.
Cervical
Cancer
Cells
Cervicalcancercells(
cervicalsquamouscellcarcinoma
or
cervical
adenocarcinoma
)aresometimesfoundonaPaptest.However,thisfindingisveryrareforwomenwhohavebeenscreenedatregularintervals.
Formoreinformationaboutcervicalcancerandtreatment,visit:
/types/cervical
.
8
Follow-upTestsandProcedures
Keepinmindthatmostwomenwithabnormalcervicalscreeningtestresultsdonothave
cancer.However,ifyouhaveanabnormaltestresult,it’simportanttogetthefollow-upcarethatisrecommended.Nextstepsarebasedonyourchancesofdevelopingseverecervicalcellchangesthatcouldbecome
cervicalcancer
,ifnottreated.
“Mostwomenwhohaveanabnormal
testresultdonothavecervical
cancer.However,follow-uptesting
andtreatmentmaybeneeded.”
Follow-upcare
Inadditiontoyourcurrenttestresult,yourhealthcareproviderwillconsiderfactorssuchasthesewhenrecommendingfollow-upcare:
●previousscreeningtestresults,
●anyprevioustreatmentsfor
precancerous
cervicalcellchanges,and
●personalhealthfactors,suchasyourage.Youmaybeadvisedto:
●returnforarepeat
HPVtest
or
HPV/Papcotest
in1or3years,
●havea
colposcopy
and
biopsy
,or
●receivetreatment,asexplainedon
page12
.
Thegoalistodetectandtreatseverecervicalcellchangesthatcoulddevelopintocervicalcancerwhilealsodecreasingtestingandtreatmentforlesssevereconditions(
low-grade
cervicalcellchanges).
Formoreinformationaboutrisk-basedscreeningguidelines,visit:
/ucc
.
9
Whattoexpectduringacolposcopy
A
colposcopy
isaprocedurethatallowsthe
cervix
tobeexamined.Duringthisprocedure,
yourhealthcareproviderinsertsa
speculum
togentlyopenthe
vagina
andviewthecervix.Avinegarsolutionwillbeappliedtothecervixtohelpshowabnormalareas.Yourhealthcareproviderthenplacesaninstrumentcalleda
colposcope
closetothevagina.Ithasabright
lightandamagnifyinglensandallowsyourhealthcareprovidertolookcloselyatyourcervix.
Duringacolposcopy,acervical
biopsy
isusuallydone.Thisisaprocedureinwhichasampleofabnormaltissueisremovedfromthecervixsothatthecervicalcellscanbestudiedunderamicroscope.
Talkwithyourhealthcareprovidertolearnwhattoexpectduringandafteryourbiopsy
procedure.Somewomenhavebleedingand/ordischargeafterabiopsy.Othershavepain
thatfeelslikecrampsduring
menstruation
.Biopsysamplesarecheckedbya
pathologist
for
cervicalintraepithelialneoplasia(CIN)
.
Biopsyfindings:Cervicalintraepithelialneoplasia(CIN)
CIN
isthetermusedtodescribeabnormalcervicalcellsthatwerefoundonthesurfaceofthecervixafterabiopsy.
CINisgradedonascaleof1to3,basedonhowabnormalthecellslookunderamicroscopeandhowmuchofthecervicaltissueisaffected.
LSIL
(alsocalledlow-gradesquamous
intraepitheliallesion,ormild
dysplasia
)seenonaPaptestisgenerallyCIN1.
HSIL
(also
calledhigh-gradesquamousintraepitheliallesion,ormoderateorseveredysplasia)seenonaPaptestcanbeCIN2,CIN2/3,orCIN3.
●
CIN1
changesaremild,orlowgrade.Theyusuallygoawayontheirownanddonotrequiretreatment.
●
CIN2
changesaremoderateandaretypicallytreatedbyremovingtheabnormalcells.
However,CIN2cansometimesgoawayonitsown.Somewomen,afterconsultingwiththeirhealthcareprovider,maydecidetohaveacolposcopywithabiopsyevery6months.CIN2mustbetreatedifitprogressestoCIN3ordoesnotgoawayin1to2years.
●
CIN3
changesareseverelyabnormal.AlthoughCIN3isnotcancer,itmaybecomecancerandspreadtonearbynormaltissueifnottreated.Unlessyouarepregnant,itshouldbe
treatedrightaway.
10
Pregnancyandtreatmentofhigh-gradecervicalcellchanges
Ifyouarepregnantorplantobecomepregnantandarefoundtohavehigh-gradecervicalcellchanges,yourhealthcareproviderwilltalkwithyouabouttreatmentsthatarerecommendedforyouandthetimingoftheseprocedures.Dependingonyourspecificdiagnosis,youmay
betreated
postpartum
,orafterdelivery.
Questionstoaskbeforeatestorprocedure
●Whatisthepurposeofthistestorprocedure?
_________________________________________________________________________
●Whatwilltheresultstellus?
_________________________________________________________________________
●Whatwillhappenduringtheprocedure?
_________________________________________________________________________
●Howlongwilltheproceduretake?
●ShouldIlimitanyactivitiesaftertheprocedure?Forhowlong?
_________________________________________________________________________
●WhatproblemsorsideeffectsshouldIcallyouaboutaftertheprocedure?
_________________________________________________________________________
“Mydoctoransweredallmy
questionsandexplainedwhat
toexpectduringandafterthe
procedure.Thatputmeatease.”
11
TreatmentsforHigh-Grade
CervicalCellChanges
Thesetreatmentsareusedwhenawomanhashigh-gradecervicalcellchangesthathavea
highriskofdevelopingintocancer.Yourhealthcareproviderwilltalkwithyouaboutwhichtreatmentisrecommendedforyouandwhy.Thequestionsonthenextpagecanhelpyou
talkwithyourhealthcareprovidertolearnmore.
“Itwasreassuringtotalkwithmydoctor.
Shehelpedmeunderstandwhattoexpect.
Itwascomfortingtolearnhowthis
treatmentwouldhelpme.”
Commontreatmentprocedures
Treatmentsthatremoveabnormalcellsarecalled
excisional
treatments:
●
Coldknifeconization
(alsocalled
coldknifeconebiopsy
):Ascalpelorlaserknifeisusedtoremoveacone-shapedsectionofabnormaltissue.Thisprocedureisdoneatthehospitalandrequires
generalanesthesia
.
●
LEEP
(
loopelectrosurgicalexcisionprocedure
):Athinwireloop,throughwhichan
electricalcurrentispassed,isusedtoremoveabnormaltissue.
Localanesthesia
isusedtonumbthearea.Thisprocedureisdoneinyourhealthcareprovider’soffice.Ittakesonlyafewminutes,andyouwillbeawakeduringtheprocedure.
Treatmentsthatdestroyabnormalcellsarecalled
ablative
treatments:
●
Cryotherapy
:Aspecialcoldprobeisusedtodestroyabnormaltissuebyfreezingit.Thisprocedureisdoneinyourhealthcareprovider’soffice.Ittakesonlyafewminutesandusuallydoesnotrequire
anesthesia
.
●
Lasertherapy
:Alaser(narrowbeamofintenselight)isusedtodestroyabnormaltissue.Thisprocedureisdoneatthehospitaland
generalanesthesia
isused.
12
Questionstoaskbeforetreatment
●WhatarethepossibletreatmentsfortheconditionthatIhave?
____________________________________________
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