# Cervical dysplasia / carcinoma in situ (abnormal Pap smear)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Cervical Intraepithelial Neoplasia - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK544371/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD32 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
CERVICAL DYSPLASIA / CARCINOMA IN SITU (ABNORMAL PAP SMEAR)
Sources: Cervical Intraepithelial Neoplasia - StatPearls -
         https://www.ncbi.nlm.nih.gov/books/NBK544371/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class GD32 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  TESTS (8)
    - Screening Pap smear, usually liquid-based cytology, checks cell appearance for abnormality
    - High-risk HPV subtype testing can be run from the same liquid sample when indicated
    - On colposcopy, 5% acetic acid is applied and dysplastic tissue turns aceto-white
    - Lugol iodine solution can be used when acetic acid fails to show abnormalities, leaving a non-
      staining patch
    - Biopsy of any abnormal-looking area lets pathology confirm dysplasia
    - The smear samples the squamocolumnar junction, where columnar lining is being replaced by
      squamous, and that is where the trouble starts
    - That changing area is where HPV gets in, and HPV is behind more than 90% of cervical cancer
    - The smear is the reason cervical cancer became both less common and less often fatal
  IF NOT THIS - what else fits (4)
    - Cervicitis is a differential to exclude
    - Endometrial carcinoma is a differential to exclude
    - Pelvic inflammatory disease is a differential to exclude
    - Vaginitis is a differential to exclude
  Source  StatPearls "Cervical Dysplasia" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Cervical dysplasia or carcinoma-in-situ, usually picked up on an abnormal Pap smear; the
            GP orders or reviews the smear and refers for colposcopy rather than treating it
            directly. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Cervical dysplasia or carcinoma-in-situ, usually picked up on an abnormal Pap smear; the
            GP orders or reviews the smear and refers for colposcopy rather than treating it
            directly.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Postcoital or intermenstrual bleeding, a high-grade abnormality on cytology,
            or a visible cervical lesion on speculum examination: refer urgently.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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