Pap test - Knowledge (XXG)

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misconceptions regarding risk in this population for cervical cancer. Pap smears may be presented to patients as non-gendered screening procedures for cancer rather than one specific for examination of the female reproductive organs. Pap smears may trigger gender dysphoria in patients and gender-neutral language can be used when explaining the pathogenesis of cancer due to infection, emphasizing the pervasiveness of HPV infection regardless of gender.

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and repair as mild abnormalities, which are usually not associated with cervical cancer, but could cause the patient stress and result in further tests and possible treatment. Cervical cancer usually takes time to develop, so delaying the start of screening a few years poses little risk of missing a potentially precancerous lesion. For instance, screening people under age 25 does not decrease cancer rates under age 30.

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screening has little benefit but leads to greatly increased cost and many unnecessary procedures and treatments. It has been acknowledged since before 1980 that most people can be screened less often. In some guidelines, frequency depends on age; for instance in Great Britain, screening is recommended every three years for women under 50, and every five years for those over.

959:. However, the NHS recommends against cervical screening during, or in the 2 days before and after, menstruation. Pap smears can be performed during menstruation, especially if the physician is using a liquid-based test; however if bleeding is extremely heavy, endometrial cells can obscure cervical cells, and if this occurs the test may need to be repeated in 6 months. 1096: 569:

captures the ability of Pap smears to correctly identify women without cervical cancer. Various studies have revealed the specificity of Pap smears to be between 64.79 - 96.8%. While Pap smears may not be entirely accurate, they remain one of the most effective cervical cancer prevention tools. Pap smears may be supplemented with HPV DNA testing.

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an additional 10 to 20% of cancers occur in those who have not had a Pap smear in the preceding five years. About one-quarter of US cervical cancers were in people who had an abnormal Pap smear but did not get appropriate follow-up (patient did not return for care, or clinician did not perform recommended tests or treatment).

357:. Guidelines on frequency vary from every three to five years. If results are abnormal, and depending on the nature of the abnormality, the test may need to be repeated in six to twelve months. If the abnormality requires closer scrutiny, the patient may be referred for detailed inspection of the cervix by 1225:

Australia has used the Pap test as part of its cervical screening program since its implementation in 1991 which required women past the age of 18 be tested every two years. In December 2017 Australia discontinued its use of the Pap test and replaced it with a new HPV test that is only required to be

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are also done after an abnormal Pap smear. The procedure requires a trained colposcopist and can be expensive to perform. However, Pap smears are very sensitive and some negative biopsy results may represent undersampling of the lesion in the biopsy, so negative biopsy with positive cytology requires

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Failure of prevention of cancer by the Pap test can occur for many reasons, including not getting regular screening, lack of appropriate follow-up of abnormal results, and sampling and interpretation errors. In the US, over half of all invasive cancers occur in females who have never had a Pap smear;

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Saslow, Debbie; Solomon, Diane; Lawson, Herschel W.; Killackey, Maureen; Kulasingam, Shalini L.; Cain, Joanna M.; Garcia, Francisco A. R.; Moriarty, Ann T.; Waxman, Alan G.; Wilbur, David C.; Wentzensen, Nicolas; Downs, Levi S.; Spitzer, Mark; Moscicki, Anna-Barbara; Franco, Eduardo L.; Stoler, Mark

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As of 2020 the NHS maintains a cervical screening program in which women between the age of 25–49 are invited for a smear test every three years, and women past 50 every five years. Much like Australia, England uses a HPV test before examining cells that test positive using the Pap test. The test is

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Pap tests commonly examine epithelial abnormalities, such as metaplasia, dysplasia, or borderline changes, all of which may be indicative of CIN. Nuclei will stain dark blue, squamous cells will stain green and keratinised cells will stain pink/ orange. Koilocytes may be observed where there is some

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In the last decade, there have been successful attempts to develop automated, computer image analysis systems for screening. Although, on the available evidence automated cervical screening could not be recommended for implementation into a national screening program, a recent NHS Health technology

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are not at risk of developing cervical cancer because they do not have cervices. Transgender women who have had vaginoplasties and have a neo-cervix or neo-vagina have a small chance of developing cancer, according to the Canadian Cancer Society. Surgeons typically use penile skin to create the new

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Multiple studies have performed sensitivity and specificity analyses on Pap smears. Sensitivity analysis captures the ability of Pap smears to correctly identify women with cervical cancer. Various studies have revealed the sensitivity of Pap smears to be between 47.19 - 55.5%. Specificity analysis

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HPV is passed through skin to skin contact; sex does not have to occur, although it is a common way for it to spread. It takes an average of a year, but can take up to four years, for a person's immune system to clear the initial infection. Screening during this period may show this immune reaction

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The endometrium is not directly sampled with the device used to sample the ectocervix. Cells may exfoliate onto the cervix and be collected from there, so as with endocervical cells, abnormal cells can be recognised if present but the Pap test should not be used as a screening tool for endometrial

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Liquid-based cytology—The sample of (epithelial) cells is taken from the transitional zone, the squamocolumnar junction of the cervix, between the ectocervix and the endocervix. The cells taken are suspended in a bottle of preservative for transport to the laboratory, where they are analyzed using

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A single smear has an area of 25 x 50 mm and contains a few hundred thousand cells on average. Screening with light microscopy is first done on low (10x) power and then switched to higher (40x) power upon viewing suspicious findings. Cells are analyzed under high power for morphologic changes

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According to the CDC, intercourse, douching, and the use of vaginal medicines or spermicidal foam should be avoided for 2 days before the test. A number of studies have shown that using a small amount of water-based gel lubricant does not interfere with, obscure, or distort the Pap smear. Further,

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Despite this, the number of people receiving Pap tests remain lower than countries like Australia. Some believe this is due to a lack of awareness regarding the test and its availability. It has also been found that women who have chronic diseases or other reproductive diseases are less likely to

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indicative of malignancy (including enlarged and irregularly shaped nucleus, an increase in nucleus to cytoplasm ratio, and more coarse and irregular chromatin). Approximately 1,000 fields of view are required on 10x power for screening of a single sample, which takes on average 5 to 10 minutes.

507:(ACOG) and others recommend starting screening at age 21. Many other countries wait until age 25 or later to start screening. For instance, some parts of Great Britain start screening at age 25. ACOG's general recommendation is that people with female reproductive organs age 30–65 have an annual 1234:

Free Pap tests were offered from 1974–1984 before being replaced by a system in which all women over the age of 30 could have the cost of their Pap test reimbursed by the National Health Insurance in 1995. This policy was still ongoing in 2018 and encouraged women to screen at least every three

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As liquid-based preparations (LBPs) become a common medium for testing, atypical result rates have increased. The median rate for all preparations with low-grade squamous intraepithelial lesions using LBPs was 2.9% in 2006, compared with a 2003 median rate of 2.1%. Rates for high-grade squamous

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Transgender men are also typically at risk for HPV due to retention of the uterine cervix in the majority of individuals in this subgroup. As such, professional guidelines recommend that transgender men be screened routinely for cervical cancer using methods such as Pap smear, identical to the

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Guidelines on frequency of screening vary—typically every three to five years for those who have not had previous abnormal smears. Some older recommendations suggested screening as frequently as every one to two years, however there is little evidence to support such frequent screening; annual

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Screening should stop at about age 65 unless there is a history of abnormal test result or disease. There is probably no benefit in screening people aged 60 or over whose previous tests have been negative. If a woman's last three Pap results were normal, she can discontinue testing at age 65,

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However, transgender men have lower rates of cervical cancer screening than cisgender women. Many transgender men report barriers to receiving gender-affirming healthcare, including lack of insurance coverage and stigma/discrimination during clinical encounters, and may encounter provider

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The endocervix may be partially sampled with the device used to obtain the ectocervical sample, but due to the anatomy of this area, consistent and reliable sampling cannot be guaranteed. Since abnormal endocervical cells may be sampled, those examining them are taught to recognize them.

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dyes and acids are selectively retained by cells. Unstained cells cannot be seen adequately with a light microscope. Papanicolaou chose stains that highlighted cytoplasmic keratinization, which actually has almost nothing to do with the nuclear features used to make diagnoses now.

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bacteria on a Pap test is of no consequence with otherwise normal test findings and no infectious symptoms. However, if there is enough inflammation to obscure the detection of precancerous and cancerous processes, it may indicate treatment with a broad-spectrum antibiotic for

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A plastic-fronded broom is sometimes used in place of the spatula or brush. The broom is not as good a collection device, since it is much less effective at collecting endocervical material than the spatula and brush. The broom is used more frequently with the advent of

1212:). These techniques are less expensive and can be performed with significantly less training. They do not perform as well as Pap smear screening and colposcopy. At this point, these techniques have not been validated by large-scale trials and are not in general use. 1023:

In some cases, a computer system may prescreen the slides, indicating those that do not need examination by a person or highlighting areas for special attention. The sample is then usually screened by a specially trained and qualified cytotechnologist using a light

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Screening guidelines vary from country to country. In general, screening starts about the age of 20 or 25 and continues until about the age of 50 or 60. Screening is typically recommended every three to five years, as long as results are normal.

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In addition, human papillomavirus (HPV) test may be performed either as indicated for abnormal Pap results, or in some cases, dual testing is done, where both a Pap smear and an HPV test are done at the same time (also called Pap co-testing).

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Willis BH, Barton P, Pearmain P, Bryan S, Hyde C, "Cervical screening programmes: can automation help? Evidence from systematic reviews, an economic analysis and a simulation modelling exercise applied to the UK". Health Technol Assess 2005

365:, which can serve as an adjunct to Pap testing. In some countries, viral DNA is checked for first, before checking for abnormal cells. Additional biomarkers that may be applied as ancillary tests with the Pap test are evolving. 1226:

conducted once every five years from the age of 25. Medicare covers the costs of testing; however, if a patient's doctor does not allow bulk billing, they may have to pay for the appointment and then claim the Medicare rebate.

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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FA, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER (2012).

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should discontinue routine Pap tests after hysterectomy. Further tests are unlikely to detect recurrence of cancer but do bring the risk of giving false positive results, which would lead to unnecessary further testing.

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National Transgender Discrimination Survey report on health and health care : findings of a study by the National Center for Transgender Equality and the National Gay and Lesbian Task Force

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In the United States, a Pap test itself costs $ 20 to $ 30, but the costs for Pap test visits can cost over $ 1,000, largely because additional tests are added that may or may not be necessary.

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that they published contained drawings of the various cells seen in patients with no disease, inflammatory conditions, and preclinical and clinical carcinoma. The monograph was illustrated by

4551: 938:, although it is considerably rarer than cervical cancer. Because the risk of this kind of cancer is so low, cervical cancer screening is not routinely offered for those with a neo-cervix. 1543:"p16 INK4a immunocytochemistry on cell blocks as an adjunct to cervical cytology: Potential reflex testing on specially prepared cell blocks from residual liquid-based cytology specimens" 4232:"The Diagnostic Value of Vaginal Smears in Carcinoma of the Uterus**This study has been aided by the Commonwealth Fund. Presented before the New York Obstetrical Society, March 11, 1941" 3352: 544:

More frequent Pap smears may be needed to follow up after an abnormal Pap smear, after treatment for abnormal Pap or biopsy results, or after treatment of cancer (cervical, anal, etc.).

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Sample collection for thin-prep-cytology from the cervix uteri of a 39-years-old multiparous woman (4 pregnancies). The cervical brush is visible just before entering the cervix uteri.

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of the cervix has not been shown to be prevented by Pap smears. In the UK, which has a Pap smear screening program, adenocarcinoma accounts for about 15% of all cervical cancers.

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HPV can be transmitted in sex between females, so those who have only had sex with other females should be screened, although they are at somewhat lower risk for cervical cancer.

4759: 1966: 504: 425: 5138: 342:. The test remains an effective, widely used method for early detection of precancer and cervical cancer. While the test may also detect infections and abnormalities in the 275:(in both men and women). Abnormal findings are often followed up by more sensitive diagnostic procedures and, if warranted, interventions that aim to prevent progression to 4516:

Fang-Hsin Leea; Chung-Yi Lic; Hsiu-Hung Wanga; Yung-Mei Yang (2013). "The utilization of Pap tests among different female medical personnel: A nationwide study in Taiwan".

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Bristow RE, Purinton SC, Santillan A, Diaz-Montes TP, Gardner GJ, Giuntoli RL (2006). "Cost-effectiveness of routine vaginal cytology for endometrial cancer surveillance".

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After childbirth, it is recommended to wait 12 weeks before taking a Pap test because inflammation of the cervix caused by the birth interferes with test interpretation.

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dyskaryosis (of epithelium). The nucleus in koilocytes is typically irregular, indicating possible cause for concern; requiring further confirmatory screens and tests.

2370:"An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations" 4400: 5566: 4789: 3369: 4710: 4303:

Bewtra, Chhanda; Pathan, Muhammad; Hashish, Hisham (2003-10-01). "Abnormal Pap smears with negative follow-up biopsies: Improving cytohistologic correlations".

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Moyer, VA; U.S. Preventive Services Task, Force (Jun 19, 2012). "Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement".

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according to the USPSTF, ACOG, ACS, and ASCP; England's NHS says 64. There is no need to continue screening after a complete hysterectomy for benign disease.

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Pambuccian, Stefan E. (2023). "Was the Cytologic Method for Cervical Cancer Diagnosis discovered by Serendipity or by Design (hypothesis-based Research)".

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since the vaccines do not cover all HPV types that can cause cervical cancer. Also, the vaccine does not protect against HPV exposure before vaccination.

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and reduce unsatisfactory specimens. Two systems have been approved by the FDA and function in high-volume reference laboratories, with human oversight.

3136:""Completely out-at-sea" with "two-gender medicine": A qualitative analysis of physician-side barriers to providing healthcare for transgender patients" 3962:"European guidelines for quality assurance in cervical cancer screening: recommendations for clinical management of abnormal cervical cytology, part 1" 2938: 2831: 2143: 3732:

Martin-Hirsch P, Lilford R, Jarvis G, Kitchener HC (1999). "Efficacy of cervical-smear collection devices: a systematic review and meta-analysis".

1826:"Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations" 599:), and less than 0.5% of results indicate cancer; 0.2 to 0.8% of results indicate Atypical Glandular Cells of Undetermined Significance (AGC-NOS). 565:

Estimates of the effectiveness of the United Kingdom's call and recall system vary widely, but it may prevent about 700 deaths per year in the UK.

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Diamantis A, Magiorkinis E, Androutsos G (Jul 2010). "What's in a name? Evidence that Papanicolaou, not Babeș, deserves credit for the Pap test".

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Lanouette JM, Puder KS, Berry SM, Bryant DR, Dombrowski MP (1997). "Is inflammation on Papanicolaou smear a risk factor for preterm delivery?".

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ACS and others have recommended, since before 1980, that conventional cytology can be safely performed up to every three years for most women.

799: 588:) (about 2% of results)), indicating HPV infection. Although most low-grade cervical dysplasias spontaneously regress without ever leading to 4123: 3544: 3295:

Potter, Jennifer; Peitzmeier, Sarah M.; Bernstein, Ida; Reisner, Sari L.; Alizaga, Natalie M.; Agénor, Madina; Pardee, Dana J. (2015-07-10).

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Salani R, Nagel CI, Drennen E, Bristow RE (2011). "Recurrence patterns and surveillance for patients with early stage endometrial cancer".

662:. However it is not very sensitive at detecting these infections, so absence of detection on a Pap does not mean absence of the infection. 552:

The Pap test, when combined with a regular program of screening and appropriate follow-up, can reduce cervical cancer deaths by up to 80%.

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Jordan, J.; Arbyn, M.; Martin-Hirsch, P.; Schenck, U.; Baldauf, J-J.; Da Silva, D.; Anttila, A.; Nieminen, P.; Prendiville, W. (2008).

2738:"Practices of participants in the college of american pathologists interlaboratory comparison program in cervicovaginal cytology, 2006" 668: 5382: 5124: 5080: 5044: 4782: 1990:

Boulware LE, Marinopoulos S, Phillips KA, Hwang CW, Maynor K, Merenstein D, Wilson RF, Barnes GJ, Bass EB, Powe NR, Daumit GL (2007).

815: 327: 5054: 4855: 4280: 126: 4728: 4378: 3896:"Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study" 580:

In the United States, about 2–3 million abnormal Pap smear results are found each year. Most abnormal results are mildly abnormal (

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Najib, Fatemeh sadat; Hashemi, Masooumeh; Shiravani, Zahra; Poordast, Tahereh; Sharifi, Sanam; Askary, Elham (September 2020).

1800: 906:. An inflammatory component is commonly seen on Pap smears from pregnant women and does not appear to be a risk for subsequent 882: 331: 4804: 64: 2736:

Eversole GM, Moriarty AT, Schwartz MR, Clayton AC, Souers R, Fatheree LA, Chmara BA, Tench WD, Henry MR, Wilbur DC (2010).

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appraisal concluded that the 'general case for automated image analysis ha(d) probably been made'. Automation may improve

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Committee on Practice Bulletins—Gynecology (2012). "ACOG Practice Bulletin Number 131: Screening for cervical cancer".

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independently made similar discoveries in 1927. However, Babeș' method was radically different from Papanikolaou's.

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Conventional Pap—In a conventional Pap smear, samples are smeared directly onto a microscope slide after collection.

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Endocervical and endometrial abnormalities can also be detected, as can a number of infectious processes, including

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Lindsey, Kimberley; DeCristofaro, Claire; James, Janet (August 2009). "Anal Pap smears: Should we be doing them?".

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Chen, Y-Y; You, S-L; Chen, C-A; Shih, L-Y; Koong, S-L; Chao, K-Y; Hsiao, M-L; Hsieh, C-Y; Chen, C-J (2009-07-07).

2169:"Effectiveness of Cervical Screening with Age: Population based Case-Control Study of Prospectively Recorded Data" 1927:"ACOG Committee on Gynecologic Practice; Routine Pelvic Examination and Cervical Cytology Screening, Opinion #413" 148: 53: 5571: 5502: 4705: 3476: 1044:. The latter two take responsibility for reporting the abnormal sample, which may require further investigation. 60: 5116: 3634: 2417: 2218:"Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women" 86: 5576: 4893: 1103: 187: 3394: 1201:, visual inspection with acetic acid or with Lugol's, and colposcopy) and electronic detection methods (e.g., 4624: 4270: 1541:

Shidham, VinodB; Mehrotra, Ravi; Varsegi, George; D′Amore, Krista L; Hunt, Bryan; Narayan, Raj (2011-01-01).

5512: 5479: 4826: 4723: 2946: 1173:, dedicated the rest of their lives to teaching the technique to other physicians and laboratory personnel. 1170: 636: 429: 2950: 2828: 955:

cytology is not affected, nor are some STD testing. The CDC states that Pap smears can be performed during

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Snelgrove, John W; Jasudavisius, Amanda M; Rowe, Bradley W; Head, Evan M; Bauer, Greta R (December 2012).

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Michael CW (1999). "The Papanicolaou Smear and the Obstetric Patient: A Simple Test with Great Benefits".

508: 256: 93: 1648:"European Guidelines for Quality Assurance in Cervical Cancer Screening. Second Edition—Summary Document" 361:, which magnifies the view of the cervix, vagina and vulva surfaces. The person may also be referred for 5540: 5157: 5100: 1141: 1001: 874: 284: 2474: 511:, that they not get annual Pap tests, and that they do get Pap tests at three to five year intervals. 5326: 4968: 4851: 1646:

Arbyn M, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, Wiener H, Herbert A, von Karsa L (2010).

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Reisner, Sari L.; Gamarel, Kristi E.; Dunham, Emilia; Hopwood, Ruben; Hwahng, Sel (September 2013).

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International Federation for Cervical Pathology and Colposcopy (IFCPC) classification. References:

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Zheng, Wenxin; Fadare, Oluwole; Quick, Charles Matthew; Shen, Danhua; Guo, Donghui (2019-07-01).

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Obtaining a Pap smear should not cause much pain, but may be uncomfortable. Conditions such as

5474: 5389: 5298: 5105: 4903: 4606: 4533: 4498: 4457: 4439: 4420:"Effectiveness of national cervical cancer screening programme in Taiwan: 12-year experiences" 4328: 4320: 4276: 4251: 4204: 4169: 4119: 4111: 4081: 4038: 3991: 3983: 3925: 3857: 3816: 3798: 3749: 3680: 3589: 3540: 3334: 3316: 3269: 3261: 3242:"Female-to-Male Transmasculine Adult Health: A Mixed-Methods Community-Based Needs Assessment" 3214: 3175: 3157: 3116: 3093: 3054: 3046: 2976: 2920: 2877: 2808: 2757: 2687: 2679: 2635: 2617: 2567: 2526: 2450: 2392: 2288: 2247: 2198: 2123: 2094: 2065: 2013: 1948: 1905: 1876: 1847: 1775: 1715: 1677: 1574: 1458: 1391: 1278: 1185:" for diagnosing cervical abnormalities after an abnormal Pap smear. Other techniques such as 970:. The health care provider then collects a sample of cells from the outer opening or external 175: 159: 3072:

Peitzmeier, Sarah M.; Khullar, Karishma; Reisner, Sari L.; Potter, Jennifer (December 2014).

1387: 4596: 4588: 4525: 4488: 4447: 4431: 4312: 4243: 4196: 4161: 4073: 4030: 3973: 3915: 3907: 3847: 3806: 3788: 3741: 3688: 3672: 3324: 3308: 3253: 3206: 3165: 3147: 3085: 3036: 2912: 2867: 2859: 2798: 2788: 2749: 2669: 2625: 2609: 2559: 2516: 2508: 2384: 2278: 2267:"American Cancer Society Guideline for the Early Detection of Cervical Neoplasia and Cancer" 2237: 2229: 2188: 2180: 2115: 2086: 2055: 2047: 2008: 2003: 1991: 1938: 1897: 1868: 1837: 1765: 1757: 1707: 1667: 1659: 1564: 1554: 1448: 1440: 1383: 1356: 1162: 651: 326:

to look for abnormalities. The test aims to detect potentially precancerous changes (called

3477:"The Effect of Using Water-based Gel Lubricant During a Speculum Exam On Pap Smear Results" 3447: 3241: 1157:

in 1941 by Papanikolaou and Herbert F. Traut, an American gynecologist. A monograph titled

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Biscotti CV, Dawson AE, Dziura B, Galup L, Darragh T, Rahemtulla A, Wills-Frank L (2005).

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Injustice at every turn : a report of the National Transgender Discrimination Survey

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Experimental visualization techniques use broad-band light (e.g., direct visualization,

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intraepithelial lesions (median, 0.5%) and atypical squamous cells have changed little.

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Davey E, d'Assuncao J, Irwig L, Macaskill P, Chan SF, Richards A, Farnsworth A (2007).

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Salani R, Backes FJ, Fung MF, Holschneider CH, Parker LP, Bristow RE, Goff BA (2011).

1004:, although either type of collection device may be used with either type of cytology. 100: 5555: 5469: 5442: 5201: 5014: 4994: 4888: 4846: 4841: 3978: 3961: 1569: 1542: 1360: 1270: 1198: 1028:. The terminology for who screens the sample varies according to the country; in the 935: 907: 858: 806: 4340: 4216: 4050: 4003: 3761: 3210: 3024: 2699: 2579: 2300: 1727: 1403: 1326: 992:

In a conventional Pap smear, the cells are placed on a glass slide and taken to the

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Guidelines on when to begin Pap smear screening are varied, but usually begin in

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In the developed world, cervical biopsy guided by colposcopy is considered the "

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Pap tests can usually be performed during pregnancy up to at least 24 weeks of

5497: 5459: 5447: 5437: 5372: 5338: 5026: 3312: 2283: 2266: 1025: 1012: 993: 982: 978: 854: 735: 712: 693: 689: 674: 584:(typically 2–5% of Pap results) or low-grade squamous intraepithelial lesion ( 358: 323: 272: 4502: 4443: 4324: 4255: 4173: 3987: 3852: 3835: 3802: 3684: 3539:. Internet Archive. Laguna Hills, CA : Current Clinical Strategies Pub. 3320: 3265: 3257: 3161: 3152: 3120: 3050: 2980: 2683: 2674: 2657: 2621: 2571: 2512: 902:. Pap tests during pregnancy have not been associated with increased risk of 5049: 5036: 4908: 3876: 2656:

Nkwabong, Elie; Laure Bessi Badjan, Ingrid; Sando, Zacharie (January 2019).

1663: 1559: 1517:"Cervical cancer screening in England to use 'more accurate' viral DNA test" 743: 720: 697: 577:

In screening a general or low-risk population, most Pap results are normal.

339: 319: 288: 287:

and named after him. A simplified version of the test was introduced by the

31: 4610: 4537: 4461: 4435: 4332: 4208: 4165: 4085: 4042: 3995: 3929: 3861: 3820: 3753: 3338: 3273: 3218: 3179: 3097: 3058: 2881: 2812: 2761: 2691: 2639: 2530: 2396: 2292: 2251: 2202: 2127: 2098: 2069: 2017: 1952: 1909: 1880: 1851: 1779: 1761: 1719: 1681: 1578: 1462: 1395: 1099:

Cervix in relation to upper part of vagina and posterior portion of uterus.

692:

of a Pap test showing a low-grade intraepithelial lesion (LSIL) and benign

592:, dysplasia can serve as an indication that increased vigilance is needed. 4676:

OB-GYN 101: Introductory Obstetrics & Gynecology > Coccoid Bacteria

4592: 3793: 2924: 2793: 2547: 2233: 4956: 4951: 4925: 4493: 4476: 4077: 3611:"Cervical screening: support for people who feel anxious about attending" 2872: 1065:

For other cervical screening tests and human papillomavirus testing, see

362: 3836:"Assisted primary screening using the automated ThinPrep Imaging System" 1151:

The Pap test was finally recognized only after a leading article in the

966:

into the vagina, which spreads the vagina open and allows access to the

5409: 4938: 4767: 4019:"Cervical Cancer Screening: What's New? Updates for the Busy Clinician" 2658:"Pap smear accuracy for the diagnosis of cervical precancerous lesions" 2077:

Committee on Gynecologic Practice (2012). "Committee Opinion No. 534".

2051: 841:

should be present into the slide, as a proof of a good quality sampling

3777:"Screening for Cervical Cancer Using Automated Analysis of PAP-Smears" 3676: 3484: 2916: 2753: 2184: 217: 5424: 5361: 5226: 5211: 4575:

Peterson NB, Murff HJ, Cui Y, Hargreaves M, Fowke JH (Jul–Aug 2008).

4316: 4200: 2864:

10.1002/(SICI)1097-0339(199907)21:1<1::AID-DC1>3.0.CO;2-0

1711: 1257: 967: 595:

In a typical scenario, about 0.5% of Pap results are high-grade SIL (

446: 299: 280: 268: 264: 260: 3659:

Biggs, Kirsty V.; Soo Hoo, San; Kodampur, Mallikarjun (April 2022).

3025:"Committee Opinion No. 512: Health Care for Transgender Individuals" 2563: 1427:

H.; Schiffman, Mark; Castle, Philip E.; Myers, Evan R. (July 2012).

1107:

Squamous metaplasia of the cervix, with typical features. Pap stain.

1095: 4625:"Cervical screening (smear testing) | Health Information | Bupa UK" 2418:"HPV and Pap Test Results: Next Steps after an Abnormal Test - NCI" 1698:

Strander, B (2009). "At what age should cervical screening stop?".

5489: 5165: 1477:

Detailed Guide: Cervical Cancer. Can cervical cancer be prevented?

1094: 945: 354: 3353:"As a trans woman, do I need to get screened for cervical cancer" 644:

Atypical glandular cells not otherwise specified (AGC or AGC-NOS)

529:

Pap smear screening is still recommended for those who have been

4868: 4577:"Papanicolaou testing among women in the southern United States" 3370:"I'm trans or non-binary, does this affect my cancer screening?" 2216:

Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K (2001).

1992:"Systematic review: The value of the periodic health evaluation" 1489:

The American College of Obstetricians and Gynecologists (2009).

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system (SIL) is also used to describe abnormalities) caused by

4752: – Australian information about Pap tests (or Pap smears) 3511: 3452: 3193:

Poteat, Tonia; German, Danielle; Kerrigan, Deanna (May 2013).

3002: 2449:. Chicago, IL: American Society for Clinical Pathology Press. 36: 1085:

Transformation zone types, determining the Pap test location:

974:

of the cervix by scraping it with either a spatula or brush.

617:

Atypical squamous cells of undetermined significance (ASC-US)

4475:

Chen, M.-J.; Wu, C.-Y.; Chen, R.; Wang, Y.-W. (2018-10-01).

4381:. Australian Government Department of Health. 15 August 2019 3420:"Tweet misleads on cervical cancer guidance for trans women" 455:

harms of screening after hysterectomy outweigh the benefits

3395:"Cervical screening for trans men and/or non-binary people" 1029: 494:

test no longer effective and likely to give false positive

30:"Pap smear" redirects here. For the American musician, see 4017:

Zhang, Salina; McNamara, Megan; Batur, Pelin (June 2018).

1140:

The test was invented by and named after the Greek doctor

631:

High-grade squamous intraepithelial lesion (HGSIL or HSIL)

620:

Atypical squamous cells – cannot exclude HSIL (ASC-H)

279:. The test was independently invented in the 1920s by the 4477:"HPV Vaccination and Cervical Cancer Screening in Taiwan" 3536:

Gynecology and obstetrics : new treatment guidelines

1248:

free as part of the national cervical screening program.

628:

Low-grade squamous intraepithelial lesion (LGSIL or LSIL)

2495:

Raffle AE, Alden B, Quinn M, Babb PJ, Brett MT (2003).

479:

vaccine does not cover all cancer-causing types of HPV

3947:"Transformation zone (TZ) and cervical excision types" 3246:

Journal of the American Psychiatric Nurses Association

2447:

Practical principles of cytopathology. Revised edition

1349:

Journal of the American Academy of Nurse Practitioners

934:

vagina and cervix, which can contract HPV and lead to

4760:

Society of Obstetricians and Gynaecologists of Canada

4064:

Bettigole C (2013). "The Thousand-Dollar Pap Smear".

1975:

Choosing Wisely: An Initiative of the ABIM Foundation

1971:"Five Things Physicians and Patients Should Question" 1809:

Choosing Wisely: An Initiative of the ABIM Foundation

1805:"Five Things Physicians and Patients Should Question" 1607:

Choosing Wisely: An Initiative of the ABIM Foundation

1600:"Five Things Physicians and Patients Should Question" 4552:"Knowledge of Cervical Cancer Screening among Women" 2167:

Sasieni, P; Castanon, A; Cuzick, J; Snow, J (2009).

1967:

American Congress of Obstetricians and Gynecologists

505:

American Congress of Obstetricians and Gynecologists

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Cervical screening test to detect potential cancers

3781:Computational and Mathematical Methods in Medicine 1091:Type 3: Endocervical component, not fully visible. 4756:Canadian Guidelines for Cervical Cancer Screening 4711:MedlinePlus: Cervical Cancer Prevention/Screening 3635:"All About Speculums: Finding What Works for You" 2998:"Should trans men have cervical screening tests?" 1925:ACOG Committee on Gynecological Practice (2009). 1089:Type 2: Endocervical component but fully visible. 1693: 1691: 1165:, who later became a staff illustrator with the 1159:Diagnosis of Uterine Cancer by the Vaginal Smear 719:. Trichomonas organism seen in the upper right. 3586:"Excerpts from Changing Bodies, Changing Lives" 2742:Archives of Pathology & Laboratory Medicine 606:Abnormal results are reported according to the 460:had partial hysterectomy – cervix remains 4275:(3 ed.). South Africa: Juta. p. 23. 3665:Journal of Obstetrics and Gynaecology Research 5132: 4783: 4236:American Journal of Obstetrics and Gynecology 4116:Gynecologic and Obstetric Pathology, Volume 2 1830:American Journal of Obstetrics and Gynecology 1739: 1737: 1303:"Pap Smear: MedlinePlus Lab Test Information" 1154:American Journal of Obstetrics and Gynecology 8: 4687:Texas Tech University Health Sciences Center 3952:Royal College of Pathologists of Australasia 3442: 3440: 3115:. National Center for Transgender Equality. 2975:. National Center for Transgender Equality. 2711: 2709: 1421: 1419: 1417: 1415: 1413: 4140:The History of Obstetrics & Gynaecology 2824: 2822: 1590: 1588: 392:under age 21, regardless of sexual history 322:. The collected cells are examined under a 5231: 5139: 5125: 5117: 5031: 4811: 4790: 4776: 4768: 2775:Nayar, Ritu; Solomon, Diane (2004-01-01). 2348:Centers for Disease Prevention and Control 1795: 1793: 1791: 1789: 1641: 1639: 1637: 1635: 1633: 1631: 310:at the outer opening of the cervix at the 153:High-grade squamous intraepithelial lesion 147: 5081:Loop electrical excision procedure (LEEP) 4671: 4669: 4600: 4492: 4451: 4401:"Do I need to pay for my cervical screen" 3977: 3919: 3851: 3810: 3792: 3692: 3328: 3169: 3151: 3040: 2871: 2802: 2792: 2673: 2629: 2520: 2282: 2241: 2192: 2059: 2007: 1942: 1841: 1769: 1671: 1568: 1558: 1452: 962:Pap smears begin with the insertion of a 127:Learn how and when to remove this message 5055:Vaginal intraepithelial neoplasia (VAIN) 5045:Cervical intraepithelial neoplasia (CIN) 2440: 2438: 2318:"Cervical screening: programme overview" 1388:10.7326/0003-4819-156-12-201206190-00424 1102: 1080: 789:Viral cytopathic effect consistent with 641:Glandular epithelial cell abnormalities 372: 298:A Pap smear is performed by opening the 3775:Bengtsson, Ewert; Malm, Patrik (2014). 3078:American Journal of Preventive Medicine 2009:10.7326/0003-4819-146-4-200702200-00008 1294: 664: 406:test every 3–5 years if results normal 5060:Vulvar intraepithelial neoplasia (VIN) 3588:. Our Bodies Ourselves. Archived from 2829:PapScreen Victoria > Pregnant women 1433:Journal of Lower Genital Tract Disease 888:An obviously atypical cell can be seen 625:Squamous intraepithelial lesion (SIL) 138: 5567:Diagnostic obstetrics and gynaecology 4729:Cervical cancer screening information 4105: 4103: 4101: 4099: 4097: 4095: 3713:Wisconsin State Laboratory of Hygiene 3481:School of Physician Assistant Studies 3364: 3362: 2992: 2990: 2651: 2649: 2591: 2589: 2542: 2540: 1744:Sasieni P, Adams J, Cuzick J (2003). 1596:American Academy of Family Physicians 922:recommendations for cisgender women. 414:over age 65; history of normal tests 7: 3301:Journal of General Internal Medicine 1144:, who started his research in 1923. 805:Normal squamous epithelial cells in 65:adding citations to reliable sources 5147:Tests and procedures involving the 4702:The Pap Test: Questions and Answers 2602:Indian Journal of Surgical Oncology 2548:"Specificity, sensitivity and cost" 2271:CA: A Cancer Journal for Clinicians 2144:"Can Cervical Cancer Be Prevented?" 929:Transgender women who have not had 213: 5592:Papillomavirus-associated diseases 1169:. Both Papanikolaou and his wife, 1040:(BMS), advanced practitioners and 328:cervical intraepithelial neoplasia 25: 4856:HPV-positive oropharyngeal cancer 3561:"Cervical Cancer Screening - NCI" 2838:from Cancer Council Victoria 2014 2344:"HPV Vaccination Recommendations" 2222:American Journal of Public Health 1475:American Cancer Society. (2010). 996:to be checked for abnormalities. 738:of a Pap test showing changes of 330:(CIN) or cervical dysplasia; the 4720:NHS Cervical Screening Programme 4023:The American Journal of Medicine 3979:10.1111/j.1365-2303.2008.00623.x 3507:"How to book cervical screening" 2406:from the original on 2019-07-02. 1521:Cancer Research UK - Cancer News 1493:. Washington, DC. Archived from 1361:10.1111/j.1745-7599.2009.00433.x 1087:Type 1: Completely ectocervical. 1007:The sample is stained using the 881: 866: 846: 830: 814: 798: 782: 767: 751: 728: 705: 682: 667: 41: 4899:Epidermodysplasia verruciformis 4269:Krunger, TF; Botha, MH (2007). 4066:New England Journal of Medicine 3448:"Screening for Cervical Cancer" 3211:10.1016/j.socscimed.2013.02.019 3035:(6): 1454–1458. December 2011. 2265:Smith, RA; et al. (2002). 1801:Society of Gynecologic Oncology 488:, with history of hysterectomy 376:Summary of reasons for testing 350:, it is not designed to do so. 332:squamous intraepithelial lesion 52:needs additional citations for 614:Atypical squamous cells (ASC) 445:for non-cancer disease – 1: 4740: – from Lab Tests Online 4248:10.1016/s0002-9378(16)40621-6 3746:10.1016/S0140-6736(99)02353-3 3199:Social Science & Medicine 1032:, the personnel are known as 4904:Focal epithelial hyperplasia 4746: — from eMedicineHealth 4685:by Michael Hughey Hughey at 4035:10.1016/j.amjmed.2018.01.020 3140:BMC Health Services Research 3090:10.1016/j.amepre.2014.07.031 3042:10.1097/AOG.0b013e31823ed1c1 2471:"Cancer Research UK website" 2120:10.1097/AOG.0b013e318277c92a 2091:10.1097/AOG.0b013e3182680517 1944:10.1097/AOG.0b013e3181a6d022 1445:10.1097/LGT.0b013e31824ca9d5 491:discontinue routine testing 5582:Infectious causes of cancer 5536:Gynecologic ultrasonography 5266:Uterine artery embolization 4530:10.1016/j.ypmed.2013.03.001 4355:"Cervical cancer screening" 4138:M.J. O'Dowd, E.E. Philipp, 3912:10.1136/bmj.39219.645475.55 3475:Wright, Jessica L. (2010). 3029:Obstetrics & Gynecology 2905:Fetal Diagnosis and Therapy 2389:10.1016/j.ygyno.2017.03.022 2079:Obstetrics & Gynecology 1996:Annals of Internal Medicine 1902:10.1016/j.ygyno.2006.05.013 1873:10.1016/j.ygyno.2011.07.014 1376:Annals of Internal Medicine 1167:National Geographic Society 853:The cytoplasms of squamous 821:Atrophic squamous cells in 476:continue testing as normal 463:continue testing as normal 255:used to detect potentially 5608: 5149:female reproductive system 4653:Jo's Cervical Cancer Trust 4649:"About cervical screening" 4481:Journal of Global Oncology 3399:Jo's Cervical Cancer Trust 3355:. Canadian Cancer Society. 2614:10.1007/s13193-020-01118-2 2558:(12): 893. December 2007. 1843:10.1016/j.ajog.2011.03.008 1064: 917:In transgender individuals 403:age 20–25 until age 50–60 271:or womb) or, more rarely, 29: 5503:Female genital mutilation 5155: 5006:Experimental techniques: 4706:National Cancer Institute 4581:Journal of Women's Health 4424:British Journal of Cancer 4399:Cancer Institute of NSW. 3313:10.1007/s11606-015-3462-8 2284:10.3322/canjclin.52.6.342 2108:Obstetrics and Gynecology 1931:Obstetrics and Gynecology 1479:Retrieved August 8, 2011. 1216:Implementation by country 398:more harms than benefits 381:patient's characteristic 375: 338:, a sexually transmitted 214: 146: 4894:Laryngeal papillomatosis 4704: — from the U.S.'s 4305:Diagnostic Cytopathology 4189:Diagnostic Cytopathology 3853:10.1309/AGB1MJ9H5N43MEGX 3258:10.1177/1078390313500693 3153:10.1186/1472-6963-12-110 3111:Grant, Jaime M. (2011). 2971:Grant, Jaime M. (2010). 2852:Diagnostic Cytopathology 2675:10.1177/0049475518798532 2513:10.1136/bmj.326.7395.901 777:organisms on a pap test. 536:Those with a history of 5513:Clitoral hood reduction 5480:Vaginal transplantation 4724:National Health Service 3709:"Conventional Pap Test" 2947:Cancer Council Victoria 2324:. Public Health England 1560:10.4103/1742-6413.76379 1177:Experimental techniques 1171:Andromachi Papanikolaou 637:Squamous cell carcinoma 4722: — from the UK's 4487:(Supplement 2): 235s. 4436:10.1038/sj.bjc.6605139 4166:10.25162/sar-2023-0004 3533:Chan, Paul D. (2006). 2085:(2, Part 1): 421–424. 1762:10.1038/sj.bjc.6600974 1108: 1100: 1092: 1009:Papanicolaou technique 951: 715:of a Pap test showing 531:vaccinated against HPV 509:well-woman examination 5541:Hysterosalpingography 5158:Gynecological surgery 5101:Georgios Papanikolaou 4689:. Retrieved Feb 2014. 4593:10.1089/jwh.2007.0576 4112:"History of Pap Test" 2794:10.1186/1742-6413-1-4 2552:Nature Reviews Cancer 2234:10.2105/AJPH.91.6.947 1664:10.1093/annonc/mdp471 1142:Georgios Papanikolaou 1106: 1098: 1084: 1038:biomedical scientists 1002:liquid-based cytology 949: 875:Trichomonas vaginalis 677:of a normal pap smear 409:broad recommendation 285:Georgios Papanikolaou 251:(BE)) is a method of 5327:Endometrial ablation 4852:Head and neck cancer 4798:Human papillomavirus 4494:10.1200/jgo.18.94300 4405:Cancer Institute NSW 4379:"Cervical Screening" 4272:Clinical gynaecology 4078:10.1056/NEJMp1307295 4029:(6): 702.e1–702.e5. 2377:Gynecologic Oncology 1890:Gynecologic Oncology 1861:Gynecologic Oncology 1616:on November 11, 2017 1382:(12): 880–91, W312. 1327:"Cervical Screening" 861:bacilli can be seen. 791:herpes simplex virus 740:herpes simplex virus 656:herpes simplex virus 336:human papillomavirus 293:Anna Marion Hilliard 61:improve this article 5378:Cervical conization 5261:Pelvic exenteration 5179:Salpingoophorectomy 5076:Cervical conization 4518:Preventive Medicine 3840:Am. J. Clin. Pathol 3794:10.1155/2014/842037 3740:(9192): 1763–1770. 1190:careful follow-up. 452:no further testing 417:no further testing 312:transformation zone 18:Vaginal examination 5395:Cervical screening 5350:Uterine myomectomy 5322:Endometrial biopsy 4733:Cancer Research UK 4681:2014-02-22 at the 4556:iprojectmaster.com 3881:2008-09-10 at the 3374:Cancer Research UK 2834:2014-02-01 at the 2445:DeMay, M. (2007). 2368:Salani, R (2017). 2052:10.3322/caac.21139 1652:Annals of Oncology 1267:anaerobic bacteria 1239:receive the test. 1109: 1101: 1093: 1067:Cervical screening 1061:Types of screening 1048:Automated analysis 952: 839:endocervical cells 538:endometrial cancer 486:endometrial cancer 420:recommendation of 253:cervical screening 245:cervical screening 5549: 5548: 5475:Vaginal wet mount 5419: 5418: 5390:Cervical cerclage 5299:Vacuum aspiration 5114: 5113: 5106:Harald zur Hausen 5089: 5088: 4933: 4932: 4359:www.cancer.org.au 4125:978-981-13-3019-3 4072:(16): 1486–1487. 3677:10.1111/jog.15179 3546:978-1-929622-63-4 3456:. 26 October 2023 3307:(12): 1857–1864. 2917:10.1159/000264477 2754:10.5858/134.3.331 2456:978-0-89189-549-7 2185:10.1136/bmj.b2968 1803:(February 2014). 1329:. NHS. 2017-10-20 1279:vaginal discharge 1120:Practical aspects 987:cervical stenosis 857:melted out; many 498: 497: 263:processes in the 229:Papanicolaou test 225: 224: 142:Papanicolaou test 137: 136: 129: 111: 16:(Redirected from 5599: 5572:Greek inventions 5366: 5343: 5315: 5287: 5239: 5232: 5141: 5134: 5127: 5118: 5032: 4812: 4792: 4785: 4778: 4769: 4690: 4673: 4664: 4663: 4661: 4660: 4645: 4639: 4638: 4636: 4635: 4621: 4615: 4614: 4604: 4572: 4566: 4565: 4563: 4562: 4548: 4542: 4541: 4513: 4507: 4506: 4496: 4472: 4466: 4465: 4455: 4415: 4409: 4408: 4396: 4390: 4389: 4387: 4386: 4375: 4369: 4368: 4366: 4365: 4351: 4345: 4344: 4317:10.1002/dc.10329 4300: 4294: 4293: 4291: 4289: 4266: 4260: 4259: 4227: 4221: 4220: 4201:10.1002/dc.21226 4184: 4178: 4177: 4149: 4143: 4136: 4130: 4129: 4107: 4090: 4089: 4061: 4055: 4054: 4014: 4008: 4007: 3981: 3956: 3940: 3934: 3933: 3923: 3891: 3885: 3872: 3866: 3865: 3855: 3831: 3825: 3824: 3814: 3796: 3772: 3766: 3765: 3729: 3723: 3722: 3720: 3719: 3705: 3699: 3698: 3696: 3656: 3650: 3649: 3647: 3645: 3631: 3625: 3624: 3622: 3621: 3607: 3601: 3600: 3598: 3597: 3582: 3576: 3575: 3573: 3572: 3557: 3551: 3550: 3530: 3524: 3523: 3521: 3520: 3503: 3497: 3496: 3494: 3492: 3483:. Archived from 3472: 3466: 3465: 3463: 3461: 3444: 3435: 3434: 3432: 3431: 3416: 3410: 3409: 3407: 3406: 3391: 3385: 3384: 3382: 3381: 3366: 3357: 3356: 3349: 3343: 3342: 3332: 3292: 3286: 3285: 3237: 3231: 3230: 3190: 3184: 3183: 3173: 3155: 3131: 3125: 3124: 3108: 3102: 3101: 3069: 3063: 3062: 3044: 3021: 3015: 3014: 3012: 3011: 2994: 2985: 2984: 2968: 2962: 2961: 2959: 2958: 2949:. Archived from 2939:"Pregnant women" 2935: 2929: 2928: 2900: 2894: 2893: 2875: 2845: 2839: 2826: 2817: 2816: 2806: 2796: 2772: 2766: 2765: 2733: 2727: 2726: 2724: 2723: 2713: 2704: 2703: 2677: 2653: 2644: 2643: 2633: 2593: 2584: 2583: 2544: 2535: 2534: 2524: 2492: 2486: 2485: 2483: 2482: 2473:. Archived from 2467: 2461: 2460: 2442: 2433: 2432: 2430: 2429: 2414: 2408: 2407: 2405: 2374: 2365: 2359: 2358: 2356: 2354: 2340: 2334: 2333: 2331: 2329: 2314: 2308: 2307: 2286: 2262: 2256: 2255: 2245: 2213: 2207: 2206: 2196: 2164: 2158: 2157: 2155: 2154: 2140: 2134: 2131: 2114:(5): 1222–1238. 2102: 2073: 2063: 2040:CA Cancer J Clin 2029: 2011: 1985: 1983: 1981: 1963: 1957: 1956: 1946: 1937:(5): 1190–1193. 1922: 1916: 1913: 1884: 1855: 1845: 1819: 1817: 1815: 1797: 1784: 1783: 1773: 1741: 1732: 1731: 1712:10.1136/bmj.b809 1695: 1686: 1685: 1675: 1643: 1626: 1625: 1623: 1621: 1615: 1609:. Archived from 1604: 1592: 1583: 1582: 1572: 1562: 1538: 1532: 1531: 1529: 1528: 1513: 1507: 1506: 1504: 1502: 1497:on June 15, 2010 1486: 1480: 1473: 1467: 1466: 1456: 1423: 1408: 1407: 1371: 1365: 1364: 1344: 1338: 1337: 1335: 1334: 1323: 1317: 1316: 1314: 1313: 1299: 1252:Coccoid bacteria 1163:Hashime Murayama 885: 870: 855:epithelial cells 850: 834: 818: 802: 786: 771: 755: 732: 709: 686: 671: 610:. They include: 373: 267:(opening of the 235:, also known as 231:(abbreviated as 218:edit on Wikidata 210: 196: 170: 169: 151: 139: 132: 125: 121: 118: 112: 110: 69: 45: 37: 21: 5607: 5606: 5602: 5601: 5600: 5598: 5597: 5596: 5577:Cervical cancer 5552: 5551: 5550: 5545: 5528:Medical imaging 5522: 5484: 5415: 5359: 5354: 5336: 5331: 5308: 5303: 5280: 5275: 5271:Transplantation 5235: 5221: 5189:Fallopian tubes 5183: 5160: 5151: 5145: 5115: 5110: 5085: 5064: 5021: 4990:Bethesda system 4963: 4929: 4915: 4863: 4822:Cervical cancer 4806: 4799: 4796: 4765: 4698: 4693: 4683:Wayback Machine 4674: 4667: 4658: 4656: 4647: 4646: 4642: 4633: 4631: 4623: 4622: 4618: 4574: 4573: 4569: 4560: 4558: 4550: 4549: 4545: 4515: 4514: 4510: 4474: 4473: 4469: 4417: 4416: 4412: 4398: 4397: 4393: 4384: 4382: 4377: 4376: 4372: 4363: 4361: 4353: 4352: 4348: 4302: 4301: 4297: 4287: 4285: 4283: 4268: 4267: 4263: 4229: 4228: 4224: 4186: 4185: 4181: 4154:Sudhoffs Archiv 4151: 4150: 4146: 4137: 4133: 4126: 4109: 4108: 4093: 4063: 4062: 4058: 4016: 4015: 4011: 3959: 3957: 3945: 3943: 3941: 3937: 3893: 3892: 3888: 3883:Wayback Machine 3873: 3869: 3833: 3832: 3828: 3774: 3773: 3769: 3731: 3730: 3726: 3717: 3715: 3707: 3706: 3702: 3658: 3657: 3653: 3643: 3641: 3633: 3632: 3628: 3619: 3617: 3609: 3608: 3604: 3595: 3593: 3584: 3583: 3579: 3570: 3568: 3559: 3558: 3554: 3547: 3532: 3531: 3527: 3518: 3516: 3505: 3504: 3500: 3490: 3488: 3474: 3473: 3469: 3459: 3457: 3446: 3445: 3438: 3429: 3427: 3418: 3417: 3413: 3404: 3402: 3393: 3392: 3388: 3379: 3377: 3368: 3367: 3360: 3351: 3350: 3346: 3294: 3293: 3289: 3239: 3238: 3234: 3192: 3191: 3187: 3133: 3132: 3128: 3110: 3109: 3105: 3071: 3070: 3066: 3023: 3022: 3018: 3009: 3007: 2996: 2995: 2988: 2970: 2969: 2965: 2956: 2954: 2937: 2936: 2932: 2902: 2901: 2897: 2849: 2846: 2842: 2836:Wayback Machine 2827: 2820: 2774: 2773: 2769: 2735: 2734: 2730: 2721: 2719: 2715: 2714: 2707: 2662:Tropical Doctor 2655: 2654: 2647: 2595: 2594: 2587: 2564:10.1038/nrc2287 2546: 2545: 2538: 2494: 2493: 2489: 2480: 2478: 2469: 2468: 2464: 2457: 2444: 2443: 2436: 2427: 2425: 2416: 2415: 2411: 2403: 2372: 2367: 2366: 2362: 2352: 2350: 2342: 2341: 2337: 2327: 2325: 2316: 2315: 2311: 2264: 2263: 2259: 2215: 2214: 2210: 2166: 2165: 2161: 2152: 2150: 2142: 2141: 2137: 2105: 2076: 2032: 1989: 1979: 1977: 1965: 1964: 1960: 1924: 1923: 1919: 1887: 1858: 1823: 1813: 1811: 1799: 1798: 1787: 1743: 1742: 1735: 1697: 1696: 1689: 1645: 1644: 1629: 1619: 1617: 1613: 1602: 1594: 1593: 1586: 1540: 1539: 1535: 1526: 1524: 1515: 1514: 1510: 1500: 1498: 1488: 1487: 1483: 1474: 1470: 1425: 1424: 1411: 1373: 1372: 1368: 1346: 1345: 1341: 1332: 1330: 1325: 1324: 1320: 1311: 1309: 1307:medlineplus.gov 1301: 1300: 1296: 1287: 1256:The finding of 1254: 1245: 1232: 1223: 1218: 1179: 1138: 1122: 1090: 1088: 1086: 1070: 1063: 1050: 944: 919: 900:gestational age 896: 889: 886: 877: 873:Infestation by 871: 862: 851: 842: 835: 826: 819: 810: 803: 794: 787: 778: 772: 763: 756: 747: 733: 724: 710: 701: 687: 678: 672: 608:Bethesda system 590:cervical cancer 575: 550: 371: 363:HPV DNA testing 306:and collecting 277:cervical cancer 221: 206: 192: 165: 164: 154: 133: 122: 116: 113: 70: 68: 58: 46: 35: 28: 23: 22: 15: 12: 11: 5: 5605: 5603: 5595: 5594: 5589: 5584: 5579: 5574: 5569: 5564: 5554: 5553: 5547: 5546: 5544: 5543: 5538: 5532: 5530: 5524: 5523: 5521: 5520: 5518:Vestibulectomy 5515: 5510: 5505: 5500: 5494: 5492: 5486: 5485: 5483: 5482: 5477: 5472: 5467: 5462: 5457: 5456: 5455: 5453:husband stitch 5445: 5440: 5435: 5429: 5427: 5421: 5420: 5417: 5416: 5414: 5413: 5407: 5402: 5392: 5387: 5386: 5385: 5375: 5369: 5367: 5356: 5355: 5353: 5352: 5346: 5344: 5333: 5332: 5330: 5329: 5324: 5318: 5316: 5305: 5304: 5302: 5301: 5296: 5290: 5288: 5283:Uterine cavity 5277: 5276: 5274: 5273: 5268: 5263: 5258: 5253: 5248: 5242: 5240: 5229: 5223: 5222: 5220: 5219: 5217:Tubal reversal 5214: 5209: 5207:Tubal ligation 5204: 5199: 5193: 5191: 5185: 5184: 5182: 5181: 5176: 5170: 5168: 5162: 5161: 5156: 5153: 5152: 5146: 5144: 5143: 5136: 5129: 5121: 5112: 5111: 5109: 5108: 5103: 5097: 5095: 5091: 5090: 5087: 5086: 5084: 5083: 5078: 5072: 5070: 5066: 5065: 5063: 5062: 5057: 5052: 5047: 5041: 5039: 5029: 5023: 5022: 5020: 5019: 5018: 5017: 5012: 5004: 5003: 5002: 5000:Cytotechnology 4997: 4987: 4986: 4985: 4973: 4971: 4965: 4964: 4962: 4961: 4960: 4959: 4954: 4943: 4941: 4935: 4934: 4931: 4930: 4923: 4921: 4917: 4916: 4914: 4913: 4912: 4911: 4906: 4901: 4896: 4891: 4886: 4881: 4873: 4871: 4865: 4864: 4862: 4861: 4860: 4859: 4849: 4844: 4839: 4834: 4824: 4818: 4816: 4809: 4801: 4800: 4797: 4795: 4794: 4787: 4780: 4772: 4763: 4762: 4753: 4747: 4741: 4735: 4726: 4717: 4708: 4697: 4696:External links 4694: 4692: 4691: 4665: 4640: 4629:www.bupa.co.uk 4616: 4587:(6): 939–946. 4567: 4543: 4524:(6): 406–409. 4508: 4467: 4430:(1): 174–177. 4410: 4391: 4370: 4346: 4311:(4): 200–202. 4295: 4281: 4261: 4242:(2): 193–206. 4222: 4179: 4144: 4131: 4124: 4091: 4056: 4009: 3972:(6): 342–354. 3935: 3886: 3867: 3826: 3767: 3724: 3700: 3671:(4): 956–965. 3651: 3626: 3602: 3577: 3565:www.cancer.gov 3552: 3545: 3525: 3498: 3487:on 24 May 2013 3467: 3436: 3411: 3386: 3358: 3344: 3287: 3252:(5): 293–303. 3232: 3185: 3126: 3103: 3084:(6): 808–812. 3064: 3016: 2986: 2963: 2930: 2911:(4): 244–247. 2895: 2840: 2818: 2767: 2728: 2705: 2645: 2608:(3): 453–458. 2585: 2536: 2487: 2462: 2455: 2434: 2422:www.cancer.gov 2409: 2360: 2335: 2309: 2257: 2228:(6): 947–952. 2208: 2159: 2148:www.cancer.org 2135: 2133: 2132: 2103: 2074: 2030: 2002:(4): 289–300. 1986:, which cites 1958: 1917: 1915: 1914: 1885: 1856: 1820:, which cites 1785: 1733: 1687: 1658:(3): 448–458. 1627: 1584: 1533: 1508: 1481: 1468: 1439:(3): 175–204. 1409: 1366: 1355:(8): 437–443. 1339: 1318: 1293: 1292: 1291: 1286: 1283: 1253: 1250: 1244: 1241: 1231: 1228: 1222: 1219: 1217: 1214: 1178: 1175: 1137: 1134: 1121: 1118: 1079: 1078: 1074: 1062: 1059: 1049: 1046: 943: 940: 931:vaginoplasties 918: 915: 895: 892: 891: 890: 887: 880: 878: 872: 865: 863: 852: 845: 843: 836: 829: 827: 823:postmenopausal 820: 813: 811: 804: 797: 795: 793:on a pap test. 788: 781: 779: 773: 766: 764: 762:on a pap test. 760:adenocarcinoma 757: 750: 748: 734: 727: 725: 717:trichomoniasis 711: 704: 702: 688: 681: 679: 673: 666: 660:trichomoniasis 648: 647: 646: 645: 639: 634: 633: 632: 629: 623: 622: 621: 618: 574: 571: 560:Adenocarcinoma 549: 546: 496: 495: 492: 489: 481: 480: 477: 474: 467: 466: 464: 461: 457: 456: 453: 450: 438: 437: 418: 415: 411: 410: 407: 404: 400: 399: 396: 393: 389: 388: 385: 382: 378: 377: 370: 367: 241:cervical smear 223: 222: 215: 212: 211: 204: 198: 197: 190: 184: 183: 178: 172: 171: 162: 156: 155: 152: 144: 143: 135: 134: 49: 47: 40: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 5604: 5593: 5590: 5588: 5587:Medical tests 5585: 5583: 5580: 5578: 5575: 5573: 5570: 5568: 5565: 5563: 5562:Cytopathology 5560: 5559: 5557: 5542: 5539: 5537: 5534: 5533: 5531: 5529: 5525: 5519: 5516: 5514: 5511: 5509: 5506: 5504: 5501: 5499: 5496: 5495: 5493: 5491: 5487: 5481: 5478: 5476: 5473: 5471: 5470:Hymenorrhaphy 5468: 5466: 5463: 5461: 5458: 5454: 5451: 5450: 5449: 5446: 5444: 5443:Culdocentesis 5441: 5439: 5436: 5434: 5431: 5430: 5428: 5426: 5422: 5411: 5408: 5406: 5403: 5400: 5396: 5393: 5391: 5388: 5384: 5381: 5380: 5379: 5376: 5374: 5371: 5370: 5368: 5365: 5363: 5357: 5351: 5348: 5347: 5345: 5342: 5340: 5334: 5328: 5325: 5323: 5320: 5319: 5317: 5314: 5312: 5306: 5300: 5297: 5295: 5292: 5291: 5289: 5286: 5284: 5278: 5272: 5269: 5267: 5264: 5262: 5259: 5257: 5254: 5252: 5249: 5247: 5244: 5243: 5241: 5238: 5233: 5230: 5228: 5224: 5218: 5215: 5213: 5210: 5208: 5205: 5203: 5202:Salpingectomy 5200: 5198: 5195: 5194: 5192: 5190: 5186: 5180: 5177: 5175: 5172: 5171: 5169: 5167: 5163: 5159: 5154: 5150: 5142: 5137: 5135: 5130: 5128: 5123: 5122: 5119: 5107: 5104: 5102: 5099: 5098: 5096: 5092: 5082: 5079: 5077: 5074: 5073: 5071: 5067: 5061: 5058: 5056: 5053: 5051: 5048: 5046: 5043: 5042: 5040: 5038: 5033: 5030: 5028: 5024: 5016: 5015:Cervicography 5013: 5011: 5008: 5007: 5005: 5001: 4998: 4996: 4995:Cytopathology 4993: 4992: 4991: 4988: 4984: 4981: 4980: 4978: 4975: 4974: 4972: 4970: 4966: 4958: 4955: 4953: 4950: 4949: 4948: 4945: 4944: 4942: 4940: 4936: 4927: 4924:Acrochordon ( 4922: 4918: 4910: 4907: 4905: 4902: 4900: 4897: 4895: 4892: 4890: 4887: 4885: 4882: 4880: 4877: 4876: 4875: 4874: 4872: 4870: 4866: 4857: 4853: 4850: 4848: 4845: 4843: 4840: 4838: 4835: 4833: 4830: 4829: 4828: 4825: 4823: 4820: 4819: 4817: 4813: 4810: 4808: 4802: 4793: 4788: 4786: 4781: 4779: 4774: 4773: 4770: 4766: 4761: 4757: 4754: 4751: 4748: 4745: 4742: 4739: 4736: 4734: 4731: – from 4730: 4727: 4725: 4721: 4718: 4716: 4713: — from 4712: 4709: 4707: 4703: 4700: 4699: 4695: 4688: 4684: 4680: 4677: 4672: 4670: 4666: 4654: 4650: 4644: 4641: 4630: 4626: 4620: 4617: 4612: 4608: 4603: 4598: 4594: 4590: 4586: 4582: 4578: 4571: 4568: 4557: 4553: 4547: 4544: 4539: 4535: 4531: 4527: 4523: 4519: 4512: 4509: 4504: 4500: 4495: 4490: 4486: 4482: 4478: 4471: 4468: 4463: 4459: 4454: 4449: 4445: 4441: 4437: 4433: 4429: 4425: 4421: 4414: 4411: 4406: 4402: 4395: 4392: 4380: 4374: 4371: 4360: 4356: 4350: 4347: 4342: 4338: 4334: 4330: 4326: 4322: 4318: 4314: 4310: 4306: 4299: 4296: 4284: 4282:9780702173059 4278: 4274: 4273: 4265: 4262: 4257: 4253: 4249: 4245: 4241: 4237: 4233: 4226: 4223: 4218: 4214: 4210: 4206: 4202: 4198: 4194: 4190: 4183: 4180: 4175: 4171: 4167: 4163: 4159: 4155: 4148: 4145: 4141: 4135: 4132: 4127: 4121: 4117: 4113: 4106: 4104: 4102: 4100: 4098: 4096: 4092: 4087: 4083: 4079: 4075: 4071: 4067: 4060: 4057: 4052: 4048: 4044: 4040: 4036: 4032: 4028: 4024: 4020: 4013: 4010: 4005: 4001: 3997: 3993: 3989: 3985: 3980: 3975: 3971: 3967: 3966:Cytopathology 3963: 3954: 3953: 3948: 3939: 3936: 3931: 3927: 3922: 3917: 3913: 3909: 3905: 3901: 3897: 3890: 3887: 3884: 3880: 3877: 3871: 3868: 3863: 3859: 3854: 3849: 3845: 3841: 3837: 3830: 3827: 3822: 3818: 3813: 3808: 3804: 3800: 3795: 3790: 3786: 3782: 3778: 3771: 3768: 3763: 3759: 3755: 3751: 3747: 3743: 3739: 3735: 3728: 3725: 3714: 3710: 3704: 3701: 3695: 3690: 3686: 3682: 3678: 3674: 3670: 3666: 3662: 3655: 3652: 3640: 3636: 3630: 3627: 3616: 3612: 3606: 3603: 3592:on 2013-12-18 3591: 3587: 3581: 3578: 3566: 3562: 3556: 3553: 3548: 3542: 3538: 3537: 3529: 3526: 3514: 3513: 3508: 3502: 3499: 3486: 3482: 3478: 3471: 3468: 3455: 3454: 3449: 3443: 3441: 3437: 3425: 3421: 3415: 3412: 3400: 3396: 3390: 3387: 3375: 3371: 3365: 3363: 3359: 3354: 3348: 3345: 3340: 3336: 3331: 3326: 3322: 3318: 3314: 3310: 3306: 3302: 3298: 3291: 3288: 3283: 3279: 3275: 3271: 3267: 3263: 3259: 3255: 3251: 3247: 3243: 3236: 3233: 3228: 3224: 3220: 3216: 3212: 3208: 3204: 3200: 3196: 3189: 3186: 3181: 3177: 3172: 3167: 3163: 3159: 3154: 3149: 3145: 3141: 3137: 3130: 3127: 3122: 3118: 3114: 3107: 3104: 3099: 3095: 3091: 3087: 3083: 3079: 3075: 3068: 3065: 3060: 3056: 3052: 3048: 3043: 3038: 3034: 3030: 3026: 3020: 3017: 3005: 3004: 2999: 2993: 2991: 2987: 2982: 2978: 2974: 2967: 2964: 2953:on 2015-01-08 2952: 2948: 2944: 2943:papscreen.org 2940: 2934: 2931: 2926: 2922: 2918: 2914: 2910: 2906: 2899: 2896: 2891: 2887: 2883: 2879: 2874: 2873:2027.42/35304 2869: 2865: 2861: 2857: 2853: 2848: 2844: 2841: 2837: 2833: 2830: 2825: 2823: 2819: 2814: 2810: 2805: 2800: 2795: 2790: 2786: 2782: 2778: 2771: 2768: 2763: 2759: 2755: 2751: 2747: 2743: 2739: 2732: 2729: 2718: 2712: 2710: 2706: 2701: 2697: 2693: 2689: 2685: 2681: 2676: 2671: 2667: 2663: 2659: 2652: 2650: 2646: 2641: 2637: 2632: 2627: 2623: 2619: 2615: 2611: 2607: 2603: 2599: 2592: 2590: 2586: 2581: 2577: 2573: 2569: 2565: 2561: 2557: 2553: 2549: 2543: 2541: 2537: 2532: 2528: 2523: 2518: 2514: 2510: 2507:(7395): 901. 2506: 2502: 2498: 2491: 2488: 2477:on 2009-01-16 2476: 2472: 2466: 2463: 2458: 2452: 2448: 2441: 2439: 2435: 2423: 2419: 2413: 2410: 2402: 2398: 2394: 2390: 2386: 2382: 2378: 2371: 2364: 2361: 2349: 2345: 2339: 2336: 2323: 2319: 2313: 2310: 2306: 2302: 2298: 2294: 2290: 2285: 2280: 2276: 2272: 2268: 2261: 2258: 2253: 2249: 2244: 2239: 2235: 2231: 2227: 2223: 2219: 2212: 2209: 2204: 2200: 2195: 2190: 2186: 2182: 2179:: 2968–2974. 2178: 2174: 2170: 2163: 2160: 2149: 2145: 2139: 2136: 2129: 2125: 2121: 2117: 2113: 2109: 2104: 2100: 2096: 2092: 2088: 2084: 2080: 2075: 2071: 2067: 2062: 2057: 2053: 2049: 2046:(3): 147–72. 2045: 2041: 2037: 2031: 2027: 2023: 2019: 2015: 2010: 2005: 2001: 1997: 1993: 1988: 1987: 1976: 1972: 1968: 1962: 1959: 1954: 1950: 1945: 1940: 1936: 1932: 1928: 1921: 1918: 1911: 1907: 1903: 1899: 1896:(2): 709–13. 1895: 1891: 1886: 1882: 1878: 1874: 1870: 1866: 1862: 1857: 1853: 1849: 1844: 1839: 1836:(6): 466–78. 1835: 1831: 1827: 1822: 1821: 1810: 1806: 1802: 1796: 1794: 1792: 1790: 1786: 1781: 1777: 1772: 1767: 1763: 1759: 1755: 1751: 1747: 1740: 1738: 1734: 1729: 1725: 1721: 1717: 1713: 1709: 1705: 1701: 1694: 1692: 1688: 1683: 1679: 1674: 1669: 1665: 1661: 1657: 1653: 1649: 1642: 1640: 1638: 1636: 1634: 1632: 1628: 1612: 1608: 1601: 1597: 1591: 1589: 1585: 1580: 1576: 1571: 1566: 1561: 1556: 1552: 1548: 1544: 1537: 1534: 1522: 1518: 1512: 1509: 1496: 1492: 1485: 1482: 1478: 1472: 1469: 1464: 1460: 1455: 1450: 1446: 1442: 1438: 1434: 1430: 1422: 1420: 1418: 1416: 1414: 1410: 1405: 1401: 1397: 1393: 1389: 1385: 1381: 1377: 1370: 1367: 1362: 1358: 1354: 1350: 1343: 1340: 1328: 1322: 1319: 1308: 1304: 1298: 1295: 1289: 1288: 1284: 1282: 1280: 1276: 1272: 1271:metronidazole 1268: 1264: 1259: 1251: 1249: 1242: 1240: 1236: 1229: 1227: 1220: 1215: 1213: 1211: 1208: 1204: 1200: 1199:cervicography 1196: 1191: 1188: 1184: 1183:gold standard 1176: 1174: 1172: 1168: 1164: 1160: 1156: 1155: 1149: 1147: 1143: 1135: 1133: 1130: 1126: 1119: 1117: 1113: 1105: 1097: 1083: 1075: 1072: 1071: 1068: 1060: 1058: 1056: 1047: 1045: 1043: 1039: 1035: 1034:cytoscreeners 1031: 1027: 1021: 1017: 1014: 1010: 1005: 1003: 997: 995: 990: 988: 984: 980: 975: 973: 969: 965: 960: 958: 948: 941: 939: 937: 936:penile cancer 932: 927: 923: 916: 914: 911: 909: 908:preterm birth 905: 901: 893: 884: 879: 876: 869: 864: 860: 856: 849: 844: 840: 833: 828: 824: 817: 812: 808: 807:premenopausal 801: 796: 792: 785: 780: 776: 770: 765: 761: 758:Endocervical 754: 749: 745: 741: 737: 731: 726: 722: 718: 714: 708: 703: 699: 695: 691: 685: 680: 676: 670: 665: 663: 661: 657: 653: 643: 642: 640: 638: 635: 630: 627: 626: 624: 619: 616: 615: 613: 612: 611: 609: 604: 600: 598: 593: 591: 587: 583: 578: 572: 570: 566: 563: 561: 557: 553: 548:Effectiveness 547: 545: 542: 539: 534: 532: 527: 523: 519: 516: 512: 510: 506: 502: 493: 490: 487: 483: 482: 478: 475: 473: 470:has received 469: 468: 465: 462: 459: 458: 454: 451: 448: 444: 440: 439: 435: 431: 427: 423: 419: 416: 413: 412: 408: 405: 402: 401: 397: 394: 391: 390: 386: 383: 380: 379: 374: 368: 366: 364: 360: 356: 351: 349: 345: 341: 337: 333: 329: 325: 321: 317: 313: 309: 305: 301: 296: 294: 291:obstetrician 290: 286: 282: 278: 274: 270: 266: 262: 258: 254: 250: 246: 242: 238: 234: 230: 219: 209: 205: 203: 199: 195: 191: 189: 185: 182: 179: 177: 173: 168: 163: 161: 157: 150: 145: 140: 131: 128: 120: 109: 106: 102: 99: 95: 92: 88: 85: 81: 78: – 77: 73: 72:Find sources: 66: 62: 56: 55: 50:This article 48: 44: 39: 38: 33: 19: 5465:Colpocleisis 5405:Cervicectomy 5398: 5360: 5337: 5309: 5294:Hysteroscopy 5281: 5251:Hysterectomy 5246:Genitoplasty 5236: 5197:Falloposcopy 5174:Oophorectomy 5010:Speculoscopy 4976: 4947:HPV vaccines 4764: 4657:. 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