During screening for cervical cancer in a community, PAP smear of a 51 year old female shows abnormal cytology. What is the best next logical procedure?
Colposcopic examination of the cervix is the gold standard for assessing dysplasia, carcinoma in situ, and early invasive disease. Application of Lugol iodine can be a useful adjunct to the colposcopic examination. Normal mature squamous epithelium of the cervix and vagina contains glycogen and stains a dark brown color, whereas dysplastic cells lack glycogen and stain a light yellow color. Colposcopically directed biopsy is performed for visible abnormalities, including acetowhite change, abnormal vessels, ulceration, and papillary lesions. Ref: Reynolds R, Loar P.V., III (2010). Chapter 39. Gynecology. In Dohey G.M.(Eds), CURRENT Diagnosis & Treatment: Surgery, 13e.
Conisation
Colposcopy & biopsy
Hysterectomy
HPV viral DNA testing