Screening hpv mures

HPV tests can find any of the high-risk types of HPV that are commonly found in cervical Gel Papillor. Current guidelines for cervical Gel Papillor screening are: Women should start screening with the Pap test at age (Screening is not recommended for women under age ). Information to aid local providers of the NHS Cervical Screening Programme in implementing high-risk human papillomavirus (hrHPV) testing. Primary human papillomavirus (HPV) screening is a new way of looking at cervical screening (smear) samples, where the check for HPV is the first test carried out. Evidence shows doing it this way. HPV primary screening The National Cervical Screening Programme (NCSP) is planning to change the first step in the screening pathway from liquid-based cytology screening to human papillomavirus (HPV) primary screening. A date is still to be decided. Latest update: National Cervical Screening Programme – sector update August

Screening hpv mures

Screening hpv mures
Infection with a high-risk strain of the human papillomavirus has been established as a necessary but insufficient cause of Screening hpv mures Gel Papillor [footnote 1]. Specialistii recomanda ca vaccinul impotriva HPV sa fie facut baietilor si fetelor cu varste cuprinse intre 11 si 12 ani. Exista foarte multe mituri despre infectia cu HPV, asa ca e bine sa cunosti toate informatiile, ca sa nu cazi pe viitor in „plasa” informatiilor gresite despre papilomavirusul uman. To help us improve GOV. If any abnormalities were detected, a more detailed colposcopy would be required. Infectia cu HPV este, de regula, cauzata de contactul intim, piele pe piele.

Endocervical curettage : A procedure Screening hpv mures which the mucous membrane of the cervical canal is scraped using a spoon-shaped instrument called a curette. Looking for HPV types 16 or 18 Three of the laboratories tested a variation in the pathway with women who tested positive for HPV, but no abnormal cells were found. Majoritatea persoanelor cu HPV nu stiu ca sunt infectate cu acest virus si nu prezinta simptome. Women part way through follow up for cervical Gel Papillor who still have a cervix should be managed by hrHPV testing at their next test and not continue with cytology-based follow up. Preparation for implementing primary HPV screening All elements of local cervical screening programmes will need Screening hpv mures be engaged well in advance of implementation. Cervixul sau colul uterin este portiunea inferioara Screening hpv mures ingusta a uterului, care se deschide in vagin.

Completion Screening hpv mures the online training can be recorded on the local sample taker register, according to local requirements. Lancet Oncology ;10 7. High-grade dyskaryosis severeHPV positive, refer colposcopy.
9/19/ · Screening Matters Newsletter Monday, September 19, – The National Screening Unit (NSU) is pleased to be hosting two sessions on the science behind the plan to introduce HPV testing as the primary screening test in the National Cervical Screening Programme in NZ. A change to primary human papillomavirus (HPV) screening followed by liquid-based cytology (LBC) triage at five-yearly intervals instead of three, for all eligible women aged 25 to 60 years, would improve the efficiency of the CervicalCheck programme, HIQA has recommended.

Acest papilomavirus uman (human papillomavirus sau, pe scurt, HPV) cauzeaza aproape toate cazurile de Gel Papillor de col hpv.iubescstudentia.ro nu uitam ca HPV este un virus transmis prin contact sexual. In majoritatea cazurilor, infectia nu provoaca simptome, iar din acest motiv, este usor ca papilomavirusul sa fie transmis de la o persoana la alta, fara ca acestea sa stie de prezenta lui. Multe dezbateri despre Mariea Montessori există şi astăzi. Sunt oameni care se declară încântaţi de sistemul pedagogic dezvoltat de Montessori şi sunt dispuşi să plătească sume importante pentru ca urmaşii lor să fie educaţi după regulile Montessori şi sunt şi oameni, care nu înţeleg cum să aibă încredere în experienţa de lucru a femeii, când aceasta l-a abandonat pe.

Stiri despre screening hpv | hpv.iubescstudentia.ro

HPV primary screening report published - PHE Screening
Home » News. The presence of any of these HPV types in a woman for many years can lead to cell changes that may need to be treated so that cervical Gel Papillor does not occur. Negii sau verucile sunt un simptom comun al infectiei cu HPV. Sunt zone de culoare mai inchisa de pe piele, usor iesite in relief, cu partea de sus plata, care pot sa apara oriunde pe corp. Evidence shows doing it this way will cut the number of cervical Gel Papillors compared to the current method of looking Screening hpv mures cervical cells first in a laboratory cytology.

The implementation of Screening hpv mures HPV screening umres a major undertaking that will impact upon all elements of the programme and require significant service redesign.

Currently CervicalCheck screening is provided at three-yearly intervals those aged between 25 and 44 years, with to year-olds offered screening every five years. Primary HPV screening would also lead to 20 per cent more preGel Papillorous abnormalities being detected and 30 per cent more cervical Gel Papillor cases and deaths being avoided for every screening test carried out compared with the current screening strategy. Extending the screening interval to every five years is also consistent with recent recommendations in Australia and New Zealand, HIQA noted.

Compared with the current screening strategy, primary HPV screening is a better test which allows all women who participate in cervical screening to become aware of their current HPV status and those who are at higher risk of cervical Gel Papillor to be picked up earlier.
She explained that where a woman was found to be HPV-positive following primary HPV screening, a follow-up test using LBC would be carried out on that same sample to inspect for cellular abnormalities. If any abnormalities were detected, a more detailed colposcopy would be required. For this reason, we advise that the interval between screenings can be increased to every five years for those currently being screened three-yearly. A change to primary HPV screening means the same benefit is provided to women in fewer screenings. Your email address will not be published. Subsequent cytology should be reported as inadequate unless abnormal cells are found.

They must not be reported as HPV -U. If hrHPV positive, cytology triage will be performed which will be reported as inadequate unless abnormal cells are identified.
These samples should be rejected. Subsequent cytology should be reported. Subsequent cytology can be reported providing there is sufficient residual sample for processing. If there is insufficient volume it should be reported as cytology inadequate.

All staff must be trained and competent to meet the requirements of cervical screening based on primary hrHPV testing. Specific training requirements are outlined below. Local training will be required to cover changes to processes required for primary HPV screening, including but not limited to the ordering and supply of sample taking materials, sample transport, sample processing in laboratories and use of IT platforms. Engaging primary care is crucial if primary hrHPV testing is to be successfully implemented.
Sample takers have an important role in ensuring that women understand the concept of hrHPV testing and the results of their screen. It may also be a useful resource for colposcopy staff as women often have questions about hrHPV testing on attendance at colposcopy.

It is recommended that all sample takers complete the e-learning, which includes a question and answer section and certificate of completion, prior to the sample taker participating in screening with primary hrHPV testing. The eLearning resource is hosted on the eLearning for Health website. Completion of the online training can be recorded on the local sample taker register, according to local requirements.
Sample takers may also require system specific training if the LBC vial type used changes with the move to the centralised laboratory service. Sample taker training must continue to be offered to staff in areas and practices which have converted to primary HPV screening, including assessing novice sample taker competency within the programme guidance. All samples taken by sample takers in training must be clearly identified to the laboratory.

All samples with a valid hrHPV result must have a cytology sample prepared and reported, irrespective of whether the HPV result is positive or negative. Samples which give an unreliable hrHPV result do not have a cytology slide prepared and must be repeated after a period of not less than 3 months and for the purposes of sample taker training recorded as unsatisfactory.
All cytology and hrHPV test results must be logged on the laboratory IT system to give a full record of the test result, and so that feedback on cytology adequacy can be given to both sample takers in training and course organisers in the usual way. Cytology slide review in addition to hrHPV testing of samples may result in a combination of cytology and hrHPV test results which is not recognised in the primary HPV screening protocol.

For example, a hrHPV negative result in combination with high grade abnormal cytology must be reported using the appropriate HPV triage code combination, to make sure that the woman is referred to colposcopy.
A summary of test result and action code combinations which cannot be recorded as primary HPV screening tests, in particular, those which must be identified and recorded as HPV triage tests, is given below. In these circumstances, the inadequate cytology result must be disregarded for the purposes of recall. The quality of the sample must still be fed back to the sample taker with an explanation that the sample does not require repeating in 3 months and detailing the required management.

If following a hrHPV negative result the cytology sample is found to be acellular casting doubt over the validity of the hrHPV test result and a decision is made to repeat the hrHPV test in 3 months, this must be reported using code combination XUR, in accordance with section Training on a new HPV platform must be delivered by the supplier to an appropriate core of staff who can then deliver cascade training to existing and new staff.
SQAS must be provided with evidence that: If a laboratory decides to adopt more than one hrHPV testing method, staff must be trained to required level of competence in each of the tests used. All staff involved in the screening and reporting of cytology samples following primary hrHPV testing must have up-to-date knowledge of the HPV screening pathway. Training courses will be provided by programme approved cervical cytology training centres.

All colposcopists receiving primary hrHPV screening referrals are expected to complete training and undertake the relevant study. A national colposcopy e-learning module on primary HPV screening has been developed, which is hosted on the eLearning for Health website. The reconfiguration of screening laboratory services associated with implementing primary HPV screening will impact significantly on the role of the CSPL. The scale and complexity of the role will increase in providers with large screening laboratories referring women to multiple external colposcopy units, and the audit of invasive Gel Papillors across separate providers will require extra coordination.
There will also still be a need for CSPLs in those providers still providing parts of the cervical screening pathway but where there is no longer a cervical cytology laboratory.

The role of the CSPL will, therefore, be vital in ensuring that links are maintained between all elements of the local programme and that individual components of the service function together to provide the best possible service and outcomes for women. Guidance has been developed to support the requirements of the CSPL role. CSPLs new to the role and those requiring further development should attend programme approved training.
The lines of communication should be maintained throughout the transition period. Laboratories and screening and immunisation teams need to notify PCSE of: The laboratory system must have the functionality to provide the primary HPV screening flag as follows, for every individual test noting the exceptional combinations associated with novice sample takers. Technical advice for the laboratory system or middleware suppliers is available on request from Exeter. The laboratory LIMS must be able to support this new result code.

Cytology result codes X No cytology result 0? Action codes A routine recall R early repeat in 3, 12 or 36 months S suspend from recall.
It will not be formally rejected by the system and therefore no automatic warning or a system-generated error message will be provided to the laboratory when the test result is recorded. The laboratory cannot, therefore, specify a non-standard recall interval for any woman. There is no override facility for individual cases beyond those described below and so it is not possible to recall women at shorter or longer intervals than those defined in the protocol. Where there is uncertainty over the quality of the sample, these should be rejected, or accepted and reported in accordance with guidance detailed in section Samples accepted but requiring a repeat sample in 3 months must be coded as XUR or 19R as appropriate.

Code combination X0R must not be used for tests requiring 3-month repeat as it will be implemented as the default recall interval of 36 months. There are 2 valid recall intervals applicable to tests coded X0R, 29R and 09R. In each case, the woman could require recall in either 12 or 36 months. A default interval will apply to these results although an allowable alternative can be provided by the laboratory which will override the default value.
The defaults and allowable override values are: Test results will be rejected by the call or recall system if they are flagged as primary hrHPV tests and: It is recommended that the laboratory LIMS incorporates basic validation to prevent the issue of these results where possible. Women will be called for screening from age Women are currently screened every 3 years between the ages of The UKNSC is considering the evidence to support extending screening intervals for all women in the screening age range.

Women recalled for a repeat screen at 12 months due to being hrHPV positive with negative cytology at their preceding test will have a repeat hrHPV test. All hrHPV positive women will have cytology triage performed on their sample. Those with abnormal cytology will be referred to colposcopy.
Women with negative cytology will be recalled for a further 12 month repeat test 24 months from the initial screen. Women returning for a second repeat test, 24 months since the initial screening test, will receive an hrHPV test. Cytology performed here defines the urgency of referral required and assists the colposcopist.

A gynaecological referral must be made for women with a cytology result of? These women will be followed up for their hrHPV positive result in the same way as women with negative cytology by repeat screening at 12 and 24 months. When the hrHPV test result is unavailable or cytology is inadequate at any screening episode in the pathway, the sample will be repeated in no less than 3 months. Women who have an inadequate cytology test at the 24 month repeat test are an exception and will be referred to colposcopy.
Women with 2 consecutive hrHPV unavailable or cytology inadequate screening tests in any combination will be referred to colposcopy. Cytology will not be performed on any sample where an hrHPV positive result has not been obtained exception in the case of novice sample takers see section This includes samples from women attending for 12 month repeat tests.

Guidance on the criteria for assessing cytological adequacy will be published shortly on GOV. Women recently treated for cervical intraepithelial neoplasia CIN or cervical glandular intraepithelial neoplasia CGIN prior to the implementation of HPV primary screening should be managed according to the colposcopy management recommendations for the implementation of primary hrHPV screening see section 14 and appendix 2.
Follow up differs slightly to the test of cure protocols used previously, most notably in that cytology is not required for hrHPV negative women.

Women being followed up for untreated CIN1 should also be managed by hrHPV testing according to the colposcopy management recommendations for the implementation of hrHPV primary screening see section Women who have completed follow up protocols when primary hrHPV testing is implemented and are returning for their next test 36 months later will begin a new screening episode, according to the primary hrHPV screening protocol algorithm.
Women part way through follow up for cervical Gel Papillor who still have a cervix should be managed by hrHPV testing at their next test and not continue with cytology-based follow up. HIV positive women within the screening age range are eligible to be screened annually and should be invited for screening using hrHPV as the primary test rather than cytology. The management of these women will follow the protocols for primary hrHPV testing in all other aspects other than frequency of screening.

At the current time, these women remain in the programme according to screening protocols. Laboratories providing primary hrHPV testing and cytology triage to the NHS screening programme will be required to use a system of direct referral of women to colposcopy.
Direct referral reduces anxiety for women by speeding up the patient journey and facilitates improved management of clinics, reducing waiting lists and non-attender rates. An efficient system needs to be in place to correctly identify the appropriate colposcopy clinic to send the referral and ensure it is received. Women with an intact cervix who have received radiotherapy of the pelvic region for example for anal, cervical, low colorectal and vaginal Gel Papillors which means that an adequate sample cannot be obtained, are not eligible for cervical screening using primary hrHPV testing.
They can be ceased from the programme. For further information see guidance for ceasing women from the programme.

Where a woman has defaulted colposcopy following high grade abnormalities and attends for screening 12 months later through the failsafe process, she should be re-referred to colposcopy even if her result is hrHPV negative. If, however, she has defaulted colposcopy following low grade abnormalities she does not warrant re-referral to colposcopy if her result if hrHPV negative; her management will follow the usual national protocol. Women who have a private screening test remain eligible for NHS testing at appropriate intervals subject to a minimum of 3 months between samples.
Primary screening tests taken under private arrangements are managed in the following ways: Women who are due or overdue for their NHS test should be encouraged to take up their screening following a private HPV positive result.

The recommended management pathways and follow up for women being referred to colposcopy following abnormal results from primary HPV screening are summarised in Appendix 2. The implementation of primary HPV screening pathways leads to an increased number of colposcopy referrals. This compared to 3. The impact of recalling women at 12 and 24 months following HPV positive results with negative cytology amounted to an extra 1.
The first full school-based cohort of vaccinated women entering the programme in will impact this. Women with inadequate colposcopy examination are managed on the results of their referral screening test. Those with borderline changes in endocervical cells and high-grade dyskaryosis or worse cytology will be offered a large loop excision of the transformation zone LLETZ procedure.

Women with no biopsy taken, a biopsy showing no CIN , or where there was no colposcopic impression of CIN will be recalled in 36 months if their referral cytology results were negative, borderline changes in squamous cells or low-grade dyskaryosis. Women referred with borderline changes in endocervical cells and high-grade dyskaryosis or worse should have their case discussed and management agreed at the colposcopy multidisciplinary team meeting within 2 months.
If CIN is confirmed on biopsy or there is colposcopic impression of CIN1 without a biopsy, the woman will be managed according to the same protocols as women with an abnormal colposcopic appearance, detailed in the following sections. The management recommendation for women who have a colposcopic appearance consistent with CIN1 or CIN1 confirmed on biopsy is recall for screening in primary care in 12 months with hrHPV testing.

Women testing hrHPV negative at this repeat test can be recalled in 36 months, at which point they will re-start the screening protocol for primary HPV testing. Women testing positive for hrHPV at the 12 month repeat test will have cytology performed on their sample and if this is abnormal any grade they will be referred to colposcopy again.
At the second repeat test women who are hrHPV negative can be recalled in 36 months. Those who are hrHPV positive will have cytology performed. Those testing negative for cytology can also be recalled in 36 months when they will restart the screening protocol for primary HPV testing. Women with abnormal cytology will be referred to colposcopy. Those testing hrHPV negative will be recalled for screening in 36 months when they will restart the screening protocol for primary hrHPV testing.

Women who test hrHPV positive will have cytology performed but will all be referred to colposcopy again regardless of the cytology result. Rarely, women may be offered conservative management for CIN2. Such women must remain subject to close colposcopic follow up in a clinic. If screening samples are taken during this time, they will be primary hrHPV tested by the laboratory with cytology performed if hrHPV positive. All samples will initially be tested for hrHPV and those women testing negative will be recalled for the second follow up test in a further 12 months. Cytology is not required in hrHPV negative women to confirm the presence of endocervical cells.

Women testing hrHPV positive at the first follow up test will have cytology performed and all will be referred to colposcopy if follow up is in primary care. The cytology samples from these hrHPV positive women must contain endocervical cells to be considered adequate for cytology unless they contain abnormal cells. Women who have negative cytology and normal colposcopic appearance will be recalled for the second follow up test in a further 12 months. At the second follow up test women testing hrHPV negative will be recalled for further testing in 36 months, when they will restart the screening protocol for primary hrHPV testing. Women testing hrHPV positive at the second follow up test will have cytology performed and all will be referred to colposcopy if follow up is performed in primary care.
Women with abnormal cytology at either of the 2 follow up tests will be re-referred to colposcopy.

In those women where colposcopy is found to be normal or re-excision does not occur, 10 years follow up should be completed with annual hrHPV testing. All women re-referred to colposcopy due to a hrHPV positive result will be eligible to enter the CGIN post treatment follow up pathway again if they have further re-excision with complete excision margins. Follow up in clinic is recommended, however, should follow up occur in primary care an hrHPV positive result must result in a re-referral to colposcopy regardless of the cytology result. Follow up samples should be taken at least 6 months following treatment and attending early should be discouraged.
Samples taken less than 3 months post treatment must not be tested. Women being followed up for cervical Gel Papillor and who still have a cervix will be followed up with hrHPV testing at 6 and 12 months and then annual follow up for a further 9 years.

These women are usually on clinical follow up, however, should follow up testing occur in primary care an hrHPV positive result must result in a re-referral to colposcopy regardless of the cytology result. Follow up after radical trachelectomy for cervical Gel Papillor is outwith the remit of the cervical screening programme. The arrangements for follow up of these women remain within the remit of the commissioning of and provision of local gynaecological Gel Papillor services.
If the gynaecological oncology services wish to offer cytological follow up for women after radical trachelectomy then this is a local decision. If cytology is required as the primary test and not HPV , the gynaecological Gel Papillor service should negotiate with the relevant cytology laboratory and the Gel Papillor service commissioners to find a mechanism to provide this service.

The centralisation of screening laboratory services will require the consideration of a number of issues required for the continuation of the screening service across previous boundaries.
Where laboratories are to merge, or individual systems are to be decommissioned, providers must provide plans for the safe transition of data into a single system or have alternative plans to ensure continued, appropriate access to data from legacy or decommissioned systems for failsafe, audit and data reporting purposes. The providers involved must also agree who will complete the KC61 and other outstanding data returns for the population of women transferred to the new service. This may depend upon the time of year when the service transfers and SQAS will be able to advise on the most pragmatic approach. Arrangements must be in place to ensure that the data needed for the retrospective elements of the KC61 can be obtained.

Cervical cytology slides are retained and stored for a period of 10 years following reporting for review purposes.
As screening services relocate to larger centralised laboratories, provision must be made to maintain these slide archives, which remain the responsibility of the trust that reported them. Whether the archive is moved to the new screening laboratory or maintained in the current site an SLA must be put in place to ensure continued prompt access when required. Any issues arising from these slides in the future, for example, findings from invasive Gel Papillor audits, remain the legal responsibility of the provider that reported them.
The responsibility for carrying out audits of invasive cervical Gel Papillor will remain with the provider, and thus the CSPL, where the woman was diagnosed. The centralised screening laboratory must agree to arrangements or procedures for providing slide review opinions to the provider hosting the services where women are diagnosed.

This may include accessing and reviewing archived slide material originally reported at another provider as detailed above in Where archived material has been produced using a different LBC technology to that used in the screening laboratory, arrangements must be put in place for these reviews to be performed by an individual qualified to report the LBC type.
The provider must agree who will take responsibility and provide clear arrangements for the provision of laboratory failsafe for women referred to colposcopy during the 12 months prior to the transfer of screening laboratory services. Consideration must be given to the management of samples received shortly before the implementation of primary HPV screening and cytology backlogs present within screening laboratories. These samples must be primary cytology screened and provision must be made to ensure these samples are screened, hrHPV tested where applicable and reported promptly.

Services transferring elsewhere may require the continuation of the laboratory service for a period of time purely for the purpose of screening all recent samples and clearing backlogs. The role of CSPLs will require review to become aligned with the services delivered by the provider following the reorganisation of screening laboratory services. Role descriptions and meeting terms of reference and arrangements may need to be revised to take account of the changes. Where the laboratory has traditionally hosted the sample taker register, agreements must be put in place, in collaboration with the relevant SIT , to ensure the provision of this once the laboratory service has transferred to a centralised laboratory.
Systems of direct referral must be established for women referred from the screening laboratory service to colposcopy services both within and across provider boundaries as defined by zonal commissioning arrangements.

The causal relation between human papillomavirus and cervical Gel Papillor. Journal of Clinical Pathology, , International Journal of Gel Papillor ; 1. Human papillomavirus and Papanicolaou tests to screen for cervical Gel Papillor. New England Journal of Medicine ; Efficacy of human papillomavirus testing for the detection of invasive cervical Gel Papillors and cervical intraepithelial neoplasia – a randomised controlled trial. Lancet Oncology ; 11 3. Lancet Oncology ;10 7. The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England – extended follow-up of the ARTISTIC randomised trial cohort through 3 screening rounds.
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Tot ce trebuie sa stii despre HPV: Simptome & Tratament

HPV testing recommended as primary cervical screening
You are reading 1 of 15 free-access articles allowed for 30 days. By Dara Gantly 29th May A change to primary human papillomavirus HPV screening followed by liquid-based cytology LBC triage at five-yearly intervals instead of Screening hpv mures, for all eligible women aged 25 to 60 years, would improve Screening hpv mures efficiency of the CervicalCheck programme, HIQA has recommended. All eligible women aged 25 to 60 years should be screened every five years, including those vaccinated against HPV 16 and HPV 18, thus muges the number of screenings each woman has in her lifetime by two. Women would experience no change in how the cervical screening sample is collected.

Currently CervicalCheck screening is provided at three-yearly intervals those aged between 25 and 44 years, with to year-olds offered screening every five years. Primary HPV screening would also lead to 20 per Screening hpv mures more preGel Papillorous abnormalities being detected and 30 per cent more cervical Gel Papillor cases and deaths being avoided for every screening test carried out compared with the current screening strategy. Extending the screening interval to every five Scrrening is also consistent with recent recommendations in Australia and New Zealand, HIQA noted. Compared with the current screening strategy, primary HPV screening is a better test which allows all women who participate in cervical screening to become aware of their current HPV status and those who are at higher risk of cervical Gel Papillor to be picked up earlier.

She explained that where a woman was found to be HPV-positive following primary HPV screening, a follow-up test using LBC would be carried out on that Screening hpv mures sample to inspect for cellular abnormalities. If any abnormalities were detected, a more detailed colposcopy would be required. For this reason, we advise that the interval between screenings can be increased to every five years for those currently being screened Screening hpv mures. A change to kures HPV screening means the same benefit is provided to women in fewer screenings. Your email address will not be published.

Cervical screening: primary HPV screening implementation

Cervical screening: implementation guide for primary HPV screening

Each year, more than 13, women are diagnosed with cervical Gel Papillor in the Screening hpv mures States. Yet cervical Gel Papillor is one of the most preventable Gel Papillors today. In most cases cervical Gel Papillor can be prevented Screening hpv mures early detection and treatment of abnormal cell changes that occur in the cervix years before cervical Gel Papillor develops. We now know that these cell changes are caused by human papillomaviruscommonly known as HPV. The traditional test for early detection has been the Pap test.

For women age 30 and over, an HPV test is also recommended. After age 65, women older than 65 who have had adequate prior screening and Screening hpv mures not otherwise at high risk can stop screening. Women who have had a hysterectomy with removal of the cervix also do not need to be screened, unless they have a have a history of a high-grade preGel Papillorous lesions. The Pap test finds changes in the cells of the cervix the mouth of the womb that are not normal.

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