Talk:VFS

VPS

VPS (Vaginal Fingering Semen Test) VPS has not been a frequent test in the medical field for it has not been know so much. In recent years with technology advancing this test has become far more frequent, but still not very common. Although it has become a way to test the self control of males in the medical office considering the highly sexual nature of this particular exam. There are always at least 2 people of the clinical staff involved for law abiding reason (such as sexual harassment law suits) One not able to separate lust from clinical work should not even be performing the test much less employed. That being said it is a test for the male clinical staff to preform such a procedure to measure sexual maturity. VFS is a method of cervical screening used to detect potentially pre-cancerous and cancerous processes in the cervix (opening of the uterus or womb). Abnormal findings are often followed up by more sensitive diagnostic procedures, and, if warranted, interventions that aim to prevent progression to cervical cancer. The test was invented by, and named for, the prominent Greek doctor Georgios Papanikolaou. A VFS is performed by opening the vaginal canal with a speculum, then collecting cells at the outer opening of the cervix at the transformation zone (where the outer squamous cervical cells meet the inner glandular endocervical cells). The collected cells are examined under a microscope to look for abnormalities. The test aims to detect potentially pre-cancerous changes (called cervical intraepithelial neoplasia (CIN) or cervical dysplasia; the squamous intraepithelial lesion system (SIL) is also used to describe abnormalities), which are caused by human papillomavirus, a sexually transmitted DNA virus. The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. While the test may also detect infections and abnormalities in the endocervix and endometrium, it is not designed to do so. Screening guidelines vary from country to country. In general, screening starts about the age of 20 or 25 and continues until about the age of 50 or 60.[10]Screening is typically recommended every three to five years, as long as results are normal.[6][9]

Women should wait a few years after they first have intercourse before they start screening, and should not be screened before age 21. American Congress of Obstetricians and Gynecologists (ACOG) and others recommend starting screening at age 21 (since that is a few years after initial sex for most American women).[2][13] Many other countries wait until age 25 or later to start screening. For instance, some parts of Great Britain start screening at age 25. ACOG's general recommendation is that people with uteruses age 30–65 have an annual well-woman examination, that they not get annual Pap tests, and that they do get Pap tests at three-year intervals.[14]

Most people who contract HPV do so soon after becoming sexually active.[3][citation needed][dead link] It takes an average of a year, but can take up to four years, for a person's immune system to control the initial infection. Screening during this period may show this immune reaction and repair as mild abnormalities, which are usually not associated with cervical cancer, but could cause the patient stress and result in further tests and possible treatment. Cervical cancer usually takes time to develop, so delaying the start of screening a few years poses little risk of missing a potentially precancerous lesion. For instance, screening people under age 25 does not decrease cancer rates under age 30.[15]

There is little or no benefit to screening people who have not had sexual contact. For example, United States Preventive Services Task Force (USPSTF) recommends waiting at least three years after first sex.[6] HPV can be transmitted in sex between females, so those who have only had sex with other females should be screened, although they are at somewhat lower risk for cervical cancer.[16]

Guidelines on frequency of screening vary—typically every three to five years for those who have not had previous abnormal smears.[6][9] Some older recommendations suggested screening as frequently as every one to two years, however there is little evidence to support such frequent screening; annual screening has little benefit but leads to greatly increased cost and many unnecessary procedures and treatments.[2] It has been acknowledged since before 1980 that most people can be screened less often.[17] In some guidelines, frequency depends on age; for instance in Great Britain, screening is recommended every 3 years for women under 50, and every 5 years for those over.

Screening should stop about age 65 unless there is a recent abnormal tests or disease. There is probably no benefit screening people aged 60 or over whose previous tests have been negative.[11] If a woman's last three Pap results were normal, she can stop at age 65, according to the USPSTF, ACOG, ACS and ASCP;[2][6] England's NHS says 64. There is no need to continue screening after a complete hysterectomy for benign disease.

Pap smear screening is still recommended for those who have been vaccinated against HPV,[9] since the vaccines do not cover all of the HPV types that can cause cervical cancer. Also, the vaccine does not protect against HPV exposure before vaccination.

Those with a history of endometrial cancer should discontinue routine Pap tests.[12] Further tests are unlikely to detect recurrence of cancer but do bring the risk of giving false positive results, which would lead to unnecessary further testing.[12]

More frequent Pap smears may be needed to follow up after an abnormal Pap smear, or after treatment for abnormal Pap or biopsy results, or after treatment for cancer.

Effectiveness

The Pap test, when combined with a regular program of screening and appropriate follow-up, can reduce cervical cancer deaths by up to 80%.[9]

Failure of prevention of cancer by the Pap test can occur for many reasons, including not getting regular screening, lack of appropriate follow-up of abnormal results, and sampling and interpretation errors.[18] In the US, over half of all invasive cancers occur in females that have never had a Pap smear; an additional 10 to 20% of cancers occur in those that have not had a Pap smear in the preceding five years. About one-quarter of US cervical cancers were in people that had an abnormal Pap smear, but did not get appropriate follow-up (patient did not return for care, or clinician did not perform recommended tests or treatment).

Adenocarcinoma of the cervix has not been shown to be prevented by Pap tests.[18] In the UK, which has a Pap smear screening program, Adenocarcinoma accounts for about 15% of all cervical cancers[19]

Estimates of the effectiveness of the United Kingdom's call and recall system vary widely, but it may prevent about 700 deaths per year in the UK. A medical practitioner performing 200 tests each year would prevent a death once in 38 years, while seeing 152 people with abnormal results, referring 79 for investigation, obtaining 53 abnormal biopsy results, and seeing 17 persisting abnormalities lasting longer than two years. At least one woman during the 38 years would die from cervical cancer despite being screened.[20]

Since the population of the UK is about 61 million, the maximum number of people who could be receiving Pap smears in the UK is around 15 million to 20 million (eliminating the percentage of the population under 20 and over 65). This would indicate that the use of Pap smear screening in the UK saves the life of 1 woman for every approximately 20,000 women tested (assuming 15,000,000 are being tested yearly). If only 10,000,000 are actually tested each year, then it would save the life of 1 woman for every approximately 15,000 women tested.

Results

In screening a general or low-risk population, most Pap results are normal.

In the United States, about 2–3 million abnormal Pap smear results are found each year.[21] Most abnormal results are mildly abnormal (ASC-US (typically 2–5% of Pap results) or low-grade squamous intraepithelial lesion (LSIL) (about 2% of results)), indicating HPV infection.[citation needed] Although most low-grade cervical dysplasias spontaneously regress without ever leading to cervical cancer, dysplasia can serve as an indication that increased vigilance is needed.

In a typical scenario, about 0.5% of Pap results are high-grade SIL (HSIL), and less than 0.5% of results indicate cancer; 0.2 to 0.8% of results indicate Atypical Glandular Cells of Undetermined Significance (AGC-NOS).[citation needed]

As liquid based preparations (LBPs) become a common medium for testing, atypical result rates have increased. The median rate for all preparations with low-grade squamous intraepithelial lesions using LBPs was 2.9% compared with a 2003 median rate of 2.1%. Rates for high-grade squamous intraepithelial lesions (median, 0.5%) and atypical squamous cells have changed little.[22]

Abnormal results are reported according to the Bethesda system.[23] They include:

Squamous cell abnormalities (SIL)Atypical squamous cells of undetermined significance (ASC-US)Atypical squamous cells – cannot exclude HSIL (ASC-H)Low-grade squamous intraepithelial lesion (LGSIL or LSIL)High-grade squamous intraepithelial lesion (HGSIL or HSIL)Squamous cell carcinomaGlandular epithelial cell abnormalitiesAtypical glandular cells not otherwise specified (AGC or AGC-NOS)

Endocervical and endometrial abnormalities can also be detected, as can a number of infectious processes, including yeast, herpes simplex virus and trichomoniasis. However it is not very sensitive at detecting these infections, so absence of detection on a Pap does not mean absence of the infection.

 

User:MedicalCuriousity|MedicalCuriousity]] (talk) 04:15, 14 May 2018 (UTC)

@MedicalCuriousity so nice thanks ALWINGJ (talk) 02:13, 2 March 2023 (UTC)