Dear OncoLink "Ask The Experts,"
I had a total hysterectomy several years ago. I recently had a Pap smear that returned with HGSIL, yet I do not have a cervix. All of the information I find on the web discusses treatment modalities for cervical HGSIL, but not if located in the vaginal vault. Can you tell me what I can possibly expect for further diagnosis and treatments?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Unfortunately, women without a cervix may still suffer from dysplasia of the vagina.
The evaluation is generally the same; high-grade findings on a Pap test require a colposcopic examination of the vulva, with biopsies of abnormal areas. Biopsies verifying the presence of high-grade dysplasia may require treatment. In general, treatment options for vaginal dysplasia include excision (sometimes called upper vaginectomy), laser, or treatment with Effudex (a topical chemotherapy agent).
Jul 23, 2010 - Although prior recommendations of major societies advised cervical cytology screening in adolescents based on onset of vaginal intercourse, the American College of Obstetricians and Gynecologists now recommends that screening begin at age 21, regardless of sexual activity, due to the rarity of cervical cancer in women under 21. These recommendations have been published in the August issue of Obstetrics & Gynecology.
Jul 23, 2010
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