A test for HPV called the Digene HPV test is highly accurate and serves as both a direct diagnosis and adjuvant to the all-important Pap smear, which is a screening device that allows for an examination of cells but not tissue structure, needed for diagnosis. A colposcopy with directed biopsy is the standard for disease detection. Endocervical brush sampling at the time of Pap smear to detect adenocarcinoma and its precursors is necessary along with doctor/patient vigilance on abdominal symptoms associated with uterine and ovarian carcinoma. The diagnosis of<unk>  or cervical carcinoma requires a biopsy for histological analysis. Classification Normal cervical epithelium Historically, abnormal changes of cervical epithelial cells were described as mild, moderate, or severe epithelial dysplasia. In 1988 the National Cancer Institute developed "The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses." This system provides a uniform way to describe abnormal epithelial cells and determine specimen quality, thus providing clear guidance for clinical management. These abnormalities were classified as squamous or glandular and then further classified by the stage of dysplasia: atypical cells, mild, moderate, severe, and carcinoma. Depending on several factors and the location of the lesion,<unk>  can start in any of the three stages and can either progress or regress. The grade of squamous intraepithelial lesion can vary.<unk>  is classified in grades: Histology Grade Corresponding Cytology Description Image<unk>  1 (Grade I) Low-grade squamous intraepithelial lesion (LSIL) * Mild epithelial dysplasia * Confined to the basal 1/3 of the epithelium * Typically corresponds to infection with HPV * High rate of regression back to normal cells * Usually managed expectantly frameless<unk>  2/3 High-grade squamous intraepithelial lesion (HSIL) * Represents a mix of low- and high-grade lesions not easily differentiated by histology * HSIL+ encompasses HSIL, AGC, and cancer<unk>  2 (Grade II) * Moderate dysplasia confined to the basal 2/3 of the epithelium * Represents a mix of low- and high-grade lesions not easily differentiated by histology *<unk>  2+ encompasses<unk>  2,<unk>  3, adenocarcinoma in situ (AIS), and cancer 202x202px<unk>  3 (Grade III) * Severe dysplasia with undifferentiated neoplastic cells that span more than 2/3 of the epithelium * May involve the full thickness * May also be referred to as cervical carcinoma in situ *<unk>  3+ encompasses<unk>  3, AIS, and cancer 200px Locations of<unk>  findings can be described in terms of quadrants, or corresponding to a clock face when the subject is in supine position. Endocervical gland invasion is associated with high-grade lesions. Changes in Terminology The College of American Pathology and the American Society of Colposcopy and Cervical Pathology came together in 2012 to publish changes in terminology to describe HPV-associated squamous lesions of the anogenital tract as LSIL or HSIL as follows below:<unk>  1 is referred to as LSIL.<unk>  2 that is negative for p16, a marker for high-risk HPV, is referred to as LSIL. Those that are p16-positive are referred to as HSIL.<unk>  3 is referred to as HSIL.
Cervical intraepithelial neoplasia
Cervical polyp
Vaginal intraepithelial neoplasia
Endometrial intraepithelial neoplasia
Cervical cancer
Vaginal adenosis
Endometrial polyp
Vaginal cancer