Cervical cancer screening tests: Techniques for cervical cytology and human papillomavirus testing
- Sarah Feldman, MD, MPH
Sarah Feldman, MD, MPH
- Associate Professor
- Harvard Medical School
- Christopher P Crum, MD
Christopher P Crum, MD
- Department of Pathology
- Brigham and Women's Hospital
Cervical cancer screening detects preinvasive neoplasia, thereby making treatment possible before the disease becomes invasive; invasive disease may also be detected. Screening is performed using cervical cytology (Pap test) or a human papillomavirus (HPV) test, or a combination of the two tests.
Techniques for obtaining specimens for cervical cytology and HPV testing are reviewed here. Screening strategies and interpretation of the cervical cytology report are discussed separately. (See "Screening for cervical cancer" and "Cervical and vaginal cytology: Interpretation of results (Pap test report)".)
HOW TO OBTAIN A SAMPLE
Cell samples for cervical cytology and human papillomavirus (HPV) testing are obtained during the speculum examination. With certain types of Pap tests, the same specimen can be used for both tests; alternatively, separate specimens can be obtained.
Specimens for cytology — There are two methods for preparing a specimen for cervical cytology: the conventional Pap smear and the liquid-based, thin layer preparation.
For both methods, cells are obtained from the external surface of the cervix (ectocervix) and the cervical canal (endocervix) to evaluate the transformation zone (squamocolumnar junction), the area at greatest risk for neoplasia.
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- HOW TO OBTAIN A SAMPLE
- Specimens for cytology
- - Collection device
- - Sample collection
- - Preparation methods
- HPV testing
- - Cervical testing
- - Other methods
- Additional tests
- - Gonorrhea, chlamydia, and trichomonas
- - Biopsy of visible lesions
- Challenges in collecting samples
- SAMPLE INTERPRETATION
- Cytologic analysis
- HPV testing result reporting
- MISPERCEPTIONS ABOUT FACTORS THAT INTERFERE WITH SAMPLING
- Menses or other genital tract bleeding
- Interval between Pap tests
- Gel lubricants and other contaminants
- Vaginal intercourse, douching, and tampon use
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS