了解宫颈变化：健康指南

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?

____________________________________________