STD GENITAL WARTS: IF THE PAP SMEAR COMES BACK AS A HIGHER-GRADE LESION
If the Pap smear comes back as a higher-grade lesion (CIN II or III, moderate or severe dysplasia, or high-grade SIL), then a colposcopy is recommended, with a biopsy of any abnormal areas and treatment as appropriate. About a third of the changes in this category progress to cancer if not treated. Close follow-up is essential.
Class IV
CIN system: CIN IV
Descriptive system: carcinoma in situ (CIS) Bethesda system: high-grade SIL
Although this is not a finding of cancer, it indicates more worrisome changes than those described previously and has a higher chance to progress to cancer. A colposcopy should be performed, and treatment is indicated if any malignant changes are found.
Class V
CIN system: invasive squamous cell carcinoma or adenocarcinoma Descriptive system: positive for malignant cells Bethesda system: squamous cell carcinoma or adenocarcinoma This finding indicates invasive cervical cancer—either squamous cell carcinoma, which results from malignant changes in the outer cells of the cervix, or adenocarcinoma, which results from malignant changes in the inner cells of the cervix. A colposcopy must be performed, and treatment is indicated if any sign of malignant changes is found.
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