Cytology

What is cytology?

Cytology, also known as Pap smear, is a test performed during the annual gynecological examination.

This technique is mainly used for the diagnosis of cervical cancer precursor lesions or cancer itself. In addition, it also allows the diagnosis of other infections in the area.

What does it consist of?

It is a very simple technique that is not painful. It consists of taking a sample of cells from the vagina and cervix by means of a brush and a spatula used to gently scrape the inside of the uterus.

Who is it intended for and when is it recommended?

It is recommended to be performed from the age of 20 or earlier if sexual relations have been previously had. In addition, it is advisable to repeat it every 3 years if the results are normal.

It is also important to remember that it is not recommended that women who have not had sexual intercourse undergo a Pap smear, as some cancers are associated with a previous HPV infection and are only transmitted during intercourse.

How is it performed?

Sampling is not painful and does not involve any risk. In some cases, small amounts of bleeding may occur, but this is not very common.

Steps to perform the cytology:

1. A speculum is inserted into the vagina and the vaginal walls are separated so that the cervix can be visualized.
2. A sample is taken from the vaginal walls, the endocervical canal and the external part of the cervix.
3. The samples are placed on a slide and analyzed.

Preparation for cytology

Cytology does not require special preparation, as it is performed during a gynecological examination. However, it is advisable to follow the recommendations below:

• Having finished menstruation 3 or 4 days before.
• Do not have sexual intercourse 48 hours before the test.
• Do not wash internally or use vaginal deodorants.

Interpretation of the results

Occasionally there may be findings that do not correspond to cervical cancer and still require treatment or a period of follow-up. The cytology result is normal when the cells analyzed correspond to those that constitute a healthy vagina and cervix.

There are different scales to measure the degree of abnormality of the sample, from the classical method to the “TBS” classification. The classical method describes the abnormality on a scale of 1 to 5.

The values that the sample can take are:

1. Normal.
2. Atypical.
3. Dysplasia.
4. Carcinoma in situ.
5. Non-invasive cancer.

On the other hand, the “TBS” scale classifies cytology as follows:

• ASCUS: atypical cells of doubtful significance.
• LGSIL: low grade changes or HPV infection.
• HGSIL: high grade lesion.
• Cancer.

It should be remembered that cytology is not useful for the diagnosis of other gynecological cancers such as ovarian or uterine cancer, but it does allow for the assessment of the possible existence of vaginal infections.

Which specialist performs the cytology?

The gynecologist will be in charge of performing the test.