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The Bethseda Pap Smear testing and evaluation is a system that was created in 1988 to display the results of a Pap smear and cytologic diagnosis. The approach reframes the Pap Smear request, primarily in the guise of a medical consultation. The pathologist, in this scenario, is primarily responsible for presenting the Pap smear results and making recommendations. The Bethesda systems typically require a separate Pap smear report that evaluates the types of epithelial alterations as well as specimen adequacy (Solomon et al, 2002).
Squamous cell abnormalities are often classified based on their biological potential. For instance, cervical intraepithelial neoplasia, human papilloma lesions, and grade 1 (CIN I) are normally grouped as low-grade squamous intraepithelial lesions (Wright et al, 2007).
Abnormal pap smear tests are caused by changes in cells as a result of various kinds of infections as seen in those triggered by the action of yeast or bacteria. Under normal circumstances, the changes normally occur as a result of various kinds of human papillomavirus, also commonly known as HPV (Wright et al, 2007). HPV is a sexually transmitted disease. However, when infections caused by yeast or bacteria cause the cell to change, there is an occurrence of an abnormal pap smear test. Therefore, such infections can be treated. Moreover, having an impaired immune system or smoking can also increase an individual’s chances of having various cell changes in the cervix. Other reasons for abnormal pap results include: HPV, Trichomoniasis, herpes, inflammation, and other forms of sexually transmitted infections.
Treatment for abnormal test results in an outpatient setting includes satisfactory colposcopy and CIN I. This includes follow up without treatment with HPV and PAP test at 6 months. This is commonly known as “watch and wait.” If the test is still positive, one should repeat the colposcopy. Another approach is treating the condition immediately using a loop electrosurgical excision or cryotherapy. The main goal is to remove the various abnormal cells as well as shed the top layer that tends to hold the virus.
Solomon D; Davey D & Kurman R (2002). The 2001 Bethesda System: terminology for reporting results of cervical cytology. Journal of American Association. 287(16): 2114-9
Wright TC Jr.; Massad L.S;L Duncton CJ; Spitzer M; Wilikinson E.J & Solomon D (2007). 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. American Journal of Obstetrician Gynecology. 197(4): 346-55
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