CERVICAL CANCER

SCREENING- PAP
SMEAR
Ellenor Chance BSN, RN
Charslesetta Johnson BSN, RN
Christiana Ikome BSN,RN

CERVICAL CANCER

Cervical cells of the grow out of control

Preventable through screening test and
vaccination
High survival rate when treated early
Occurs most often in women over 30
HPV most common cause (at least half of
sexually active individuals will have HPV in
their lifetime)

CERVICAL CANCER S/S AND

PRESENTATION

Most common symptoms reported by patients

include:
Abnormal Vaginal bleeding usually post coital
Vaginal Discomfort
Malodorous Discharge and dysuria.

CERVICAL CANCER DIFF

DIAGNOSIS

Cervicitis infection: an inflammation of the

uterine cervix.
Endometrial CA- genital female CA
PID - Pelvic inflammatory disease: and
infection of the uterus, fallopian tubes and
adjacent structures.
Primary melanoma
Vaginal CA
Primary CA with metastasis to the cervix

CERVICAL CANCER STAGES

Stage IA2 two options

Radical Vaginal trachelectomy and pelvic
lymph node dissection.
Stage IIB, III or IVA - locally advanced cervical
CA treatment is radiation and chemotherapy.
Stage IVB and recurrent disease: treatment is
individualized and therapy consists mostly of
palliative radiation of radiation and
chemotherapy.

CERVICAL CA STAGES : MORE INFORMATION

http://www.cancer.gov/cancertopics/pdq/tr
eatment/cervical/Patient/page2#Keypoint11

CERVICAL CANCER TREATMENTS

For Early invasive Cancer of the cervix,

surgery is the treatment of choice.
Advanced cases Radiation and chemo therapy
is the current standard of care
Disseminated disease: chemotherapy and or
radiation are used to help reduce symptoms
and provide palliation.
Treatment requires a multi-disciplinary
approach.

PAP SMEAR

Medical procedure in which sample cells are

collected from the cervix, smeared on a
microscopic slide, and examined under a
microscope.
Identifies minor cells changes before they
have had a chance to become malignant.
Used as a screening tool for cervical cancer
ONLY does not identify other gynecological
cancers.

PAP-SMEAR INDICATION

Recommended for women age 21-65 yrs old

Sexually active women
Pregnant women
Women with subtotal hysterectomy
Women with total hysterectomy secondary to
malignancy
*not indicated for women with total
hysterectomy for benign reasons

PAP SMEAR PROCEDURE

Should be done before bimanual

Should be collected before any other test
except wet mount.
Sample should be collected from the
transformation zone or squamocolumnar
junction.
Liquid base collection: Thin Prep and Sure
Prep are the most commonly used

PAP SMEAR TECHNIQUE

With the woman positioned on her back, examine the

outside of the patient's genital and rectal areas
A speculum is then inserted into the vaginal area.
A cotton swab may be used to clear away mucus that
might interfere with an optimal sample.
A cervical brush is then inserted into the cervical os and
twirled around to collect a sample of cells (endocervical
sample)
A second sample is also collected as part of the Pap smear
from scraping of the area surrounding, but not entering,
the cervical os (extocervical exam)
Both the endocervical and the ectocervical samples are
gently smeared on a glass slide and a preservative is used
to prepare the cells on the slide for laboratory evaluation.

PAP-SMEAR

PAP- SMEAR PATIENT TEACHING

Do not douche (rinse the vagina with water

or another fluid).
Do not use a tampon.
Avoid sex
Avoid using birth control foams, creams, or
jellies.
Avoid using medicines or creams in the
vagina.

LINKS FOR THE CERVICAL SCREENING GUIDE LINE

INFORMATION.

http://
americanpregnancy.org/womenshealth/papsm
ear.html
www.cdc.gov/cancer/cervical/pdf/guidelines
.pdf
www.cdc.gov/mmwr/preview/mmwrhtml/mm
6151a3.htm?s_cid=mm6151a3_w
m.cdc.gov/en/HealthSafetyTopics/DiseasesC
onditions/Cancer/Gynecologic/Cervical/scre
ening