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# Cervical cancer screening and prevention

- Technique

Cervical cancer takes years to develop from a visible precursor; screening finds it in that window and the vaccine stops the infection that starts it.

Updated Nov 12, 2026

## Key points

- Pap cytology: cells scraped from the transformation zone are examined for abnormal nuclei; reported with the Bethesda terms.
- HPV testing is more sensitive than cytology for high-grade lesions and allows longer intervals; cytology or other tests then triage the positives.
- Colposcopy with acetic acid shows the lesion so it can be biopsied; high-grade lesions are excised (loop or cone) or ablated.
- Vaccines are made of virus-like particles (no viral DNA); all cover HPV 16 and 18; best given before sexual debut.
- Where colposcopy is hard to reach, visual inspection with acetic acid followed by immediate treatment is used.

## What it is

Cervical cancer is one of the most preventable cancers because its precursor lasts years and lives on a surface that can be sampled. Screening uses cytology (the Pap test), testing for high-risk HPV, or both; abnormal results lead to colposcopy, biopsy and treatment of high-grade lesions. Vaccination against HPV, given before sexual exposure, prevents the infections behind most cases, but vaccinated women still need screening.

## Step by step

- Sample: a brush collects cells from the ectocervix, the transformation zone and the endocervical canal.
- Test: the sample is tested for high-risk HPV, read as cytology, or both.
- Triage: positive results are sorted by HPV type, cytology or other markers to decide who needs colposcopy.
- Colposcopy and biopsy confirm whether there is HSIL, adenocarcinoma in situ or invasion.
- Treatment removes high-grade lesions; follow-up testing confirms clearance.

## Bethesda cytology categories and what they mean

| Category | Meaning | Usual next step |
| --- | --- | --- |
| NILM | No intraepithelial lesion or malignancy | Routine screening |
| ASC-US | Atypical squamous cells of undetermined significance | HPV test or repeat cytology |
| ASC-H | Atypical squamous cells, cannot exclude HSIL | Colposcopy |
| [LSIL](https://durgical.com/en/conditions/cervical-intraepithelial-neoplasia/) | Low-grade squamous intraepithelial lesion | Colposcopy or follow-up depending on age and HPV |
| [HSIL](https://durgical.com/en/conditions/cervical-intraepithelial-neoplasia/) | High-grade squamous intraepithelial lesion | Colposcopy and treatment |
| AGC or AIS | Atypical glandular cells or adenocarcinoma in situ | Colposcopy and endocervical (and often endometrial) sampling |

## Clinical notes

- Most cervical cancers occur in women who were never screened or who were not followed up after an abnormal result.
- Colombia vaccinates schoolgirls against HPV and screens with cytology and HPV testing; access and follow-up remain uneven between cities and rural areas.
- Screening is a public-health tool: the exact ages and intervals follow each country's guideline.

## Memory aid

Vaccine closes the door, HPV test rings the bell, cytology looks through the window, and colposcopy opens the room.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does cervical cancer screening work so well?

The precursor lasts years, sits on an accessible surface that can be sampled, and can be treated simply before it invades.

## What does ASC-H mean on a Pap report?

Atypical squamous cells for which a high-grade lesion cannot be excluded; colposcopy is indicated.

## Do vaccinated women still need screening, and why?

Yes; vaccines do not cover every high-risk type and do not clear infections already present.

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[More Pathology questions →](https://durgical.com/en/practice/?f=pathology)

## Elsewhere in DurgiPedia

- [Cervix and vagina: the transformation zone](https://durgical.com/en/histology/cervix-and-vagina-the-transformation-zone/)
- [Gynecologic examination: speculum and bimanual exam](https://durgical.com/en/clinical-exam/gynecologic-examination-speculum-and-bimanual-exam/)

## Connections

## Related 7

- [HPV and cervical carcinogenesis](https://durgical.com/en/general-pathology/hpv-and-cervical-carcinogenesis/)
- [Cervical squamous intraepithelial lesions (LSIL, HSIL)](https://durgical.com/en/general-pathology/cervical-squamous-intraepithelial-lesions/)
- [Invasive cervical carcinoma](https://durgical.com/en/general-pathology/invasive-cervical-carcinoma/)
- [Cytology: the Pap test, fine-needle aspiration and body fluids](https://durgical.com/en/general-pathology/cytology-the-pap-test-fine-needle-aspiration-and-body-fluids/)
- [Cancer epidemiology: age, environment, predisposing conditions (and Colombia)](https://durgical.com/en/general-pathology/cancer-epidemiology-age-environment-predisposing-conditions/)
- [Biopsy: excisional, incisional, core needle, punch and fine-needle aspiration](https://durgical.com/en/general-pathology/biopsy-excisional-incisional-core-needle-punch-and-fine-needle-aspiration/)
- [Molecular pathology: PCR, FISH, sequencing and liquid biopsy](https://durgical.com/en/general-pathology/molecular-pathology-pcr-fish-sequencing-and-liquid-biopsy/)

## Related conditions 3

- [Cervical cancer](https://durgical.com/en/conditions/cervical-cancer/)
- [Cervical intraepithelial neoplasia (cervical dysplasia)](https://durgical.com/en/conditions/cervical-intraepithelial-neoplasia/)
- [Human papillomavirus (HPV) infection](https://durgical.com/en/conditions/human-papillomavirus-infection/)

## Microorganisms 1

- [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Cervical Cancer Screening (PDQ®)–Health Professional Version](https://www.cancer.gov/types/cervical/hp/cervical-screening-pdq) (National Cancer Institute, 2026); [Human Papillomavirus](https://www.ncbi.nlm.nih.gov/books/NBK448132/) (StatPearls (NCBI Bookshelf), 2026); [Cervical cancer mortality among young women in Latin America and the Caribbean: trend analysis from 1997 to 2030](https://europepmc.org/article/PMC/PMC8761303/) (BMC public health, 2022).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/general-pathology/cervical-cancer-screening-and-prevention/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/cervical-cancer-screening-and-prevention/