From whom, when and how should cervical smear be taken?
When taking smear; The patient must have been abstinent for at least two days (not had sexual intercourse), the vagina has not been washed, vaginal treatment has not been applied, and all gynecological interventions, including examination (except endocervical culture), have not been performed.
Beginning of Screening
The beginning of smear screening should be after the age of 21. The purpose of not doing it before; Spontaneous regression of Human Papilloma Virus (HPV) infections is possible, thus unnecessary examination and treatment will be prevented in people who will spontaneously regress.
Screening Intervals
Cervical smear screening It is sufficient for the intervals to be every 3 years between the ages of 21-29. Taking it more frequently does not increase the chance of protection against cervical cancer. Between the ages of 30 and 65, if Pap smear is done alone, screening every 3 years is sufficient, if it is done together with HPV test, screening every 5 years is sufficient. Pap smear screening combined with HPV testing is more sensitive in protecting against cancer.
Screening discontinuation criteria include those who were exposed to DES in the womb, those who are HIV positive, those who are receiving immunosuppressive therapy (including chemotherapy and chronic corticosteroid therapy). It should be screened at regular intervals until it is achieved.
Cutting Screening
All authorities have agreed that screening should end at the age of 65. Pap smear screening is unnecessary at older ages.
In cases of cervical cancer, exposure to DES in the womb, or immunosuppressive treatment (including HIV-positive people), it should be continued annually until good health conditions are achieved.
>Vaginal cytology has no place in the follow-up of people whose uterus has been removed for other gynecological reasons (the presence of CIN II and III is not considered benign). For people who have undergone hysterectomy surgery, in which the cervix is not removed, the same guideline that would be applied to an individual who has not had surgery is valid. In people whose uterus has been removed due to CIN II and III; Screening should be discontinued in the absence of three normal cytology seen by the doctor and abnormal/positive cytology in the last 10 years.
Screening in Pregnant Women
Screening in pregnant women should be done in the first three months. The first three It is certain that taking a monthly smear test does not lead to miscarriage or infant death. However, spot-like bleeding may occur.
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