Glossary

When cells change, they are considered abnormal. Abnormal cells are not cancer, but they can eventually lead to cervical cancer. Abnormal cells are silent – you don’t feel ill in any way.

This means a lab performing a Pap test found abnormal cells (cell changes).

Results are ranked by the number of abnormal cells found:

• CIN 1: mild – about 60% of CIN 1 cases go away on their own
• CIN 2: moderate
• CIN 3: severe

If your result is CIN 2, CIN 3, or CIN 2/3, usually your healthcare provider will treat these abnormal cells.

Removal of a sample of tissue to examine in the laboratory.

This is also called cancer of the cervix. (The cervix is the opening from the vagina to the uterus). This cancer can spread from the cervix to the uterus (womb) and then to other parts of the body.

Cervical cancer is most common in women aged 40 to 55. But there are exceptions. Women in their 20s and 30s can get cervical cancer, and so can women older than 55.

The path to cervical cancer – HPV infection, abnormal cells, and early cancer – is silent. Over a period of years your cervix may be developing a problem without you suspecting a thing. That’s why it’s so important to get tested regularly.

The cervix (or neck of the uterus) is the lower, narrow part of the uterus (womb) where it joins with the top end of the vagina.

These are drugs (chemicals) used to stop the growth of cancer cells. Chemotherapy can be taken by mouth, or injected into a vein, muscle, spinal column, organ, or body cavity.

Any sexually active woman or man can have chlamydia – and many people have no symptoms at first. Get tested for chlamydia on a regular basis and if you have it, get treated. For more information go to www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm

CIN stands for cervical intraepithelial neoplasia, which means abnormal cell growth.

A Pap test result showing the least risky amount of abnormal cell growth. Around one-third of the cells are abnormal. About 60% of CIN 1 cases go away on their own.

Medical people sometimes use other terms to refer to CIN 1:

• Grade I CIN
• mild dysplasia
• low grade squamous intraepithelial lesion (LGSIL or LSIL)

A Pap test result showing a moderate amount of abnormal cell growth. Around two-thirds of the cells are abnormal.

Medical people sometimes use other terms to refer to CIN 2:

• Grade II CIN
• moderate dysplasia
• high grade squamous intraepithelial lesions (HSIL).

A category combining CIN 2 and CIN 3.

A Pap test result showing a severe amount of abnormal cell growth. More than two-thirds of the cells are abnormal and there may be a thick layer of these abnormal cells.

Medical people sometimes use other terms to refer to CIN 3:

• Grade III CIN
• severe dysplasia
• high grade squamous intraepithelial lesions (HSIL).
• cervical carcinoma in situ

An exam in which the cervix is viewed closely with a lighted magnifying instrument.

A person with a compromised immune system may have difficulty fighting off infections such as an HPV infection. Diseases such as lupus and HIV/AIDS can compromise the immune system. This website lists many immune diseases and support groups: http://www.dmoz.org/Health/Conditions_and_Diseases/Immune_Disorders/Auto-Immune/

This website discusses HIV/AIDS and the immune system: http://www.cdc.gov/hiv/topics/basic/

Between 1938 and 1971, DES was prescribed to many women to prevent miscarriage Its full name is diethylstilbestrol. The daughters of women given low-dose DES are at greater risk for cervical cancer.

For more information on DES go to en.wikipedia.org/wiki/Diethylstilbestrol. Here is a DES support website: www.desaction.org/

In a typical gynecological exam (also referred to as a pelvic exam), your healthcare provider looks at any risks you may have for:

• Cervical cancer
• Sexually transmitted infections
• Family planning/birth control
• Breast cancer
• Cholesterol
• High blood pressure
• Colorectal cancer (cancer in your colon or anus)
• Depression
• Osteoporosis (thinning bones)
• Bladder health
• Thyroid disease
• Diabetes
• Domestic violence

To obtain cells for a Pap and/or HPV test, your healthcare provider will ask you to lie on your back, with your bottom at the edge of the exam table, your knees bent, and your feet in stirrups. The provider inserts a device called a speculum into your vagina in order to better examine your cervix. The provider then uses a cotton swab to clean your cervix and a device to collect some sample cells.

No, this procedure isn’t fun, but it doesn’t last long – and it’s essential for your good health. The procedure is uncomfortable, but it shouldn’t be painful. If you feel pain, say so.

We use the word healthcare provider to cover a large range of medical practitioners: ob/gyn (obstetrician/gynecologist), general doctor, surgeon, nurse practitioner, registered nurse, or physician’s assistant. Make sure the person monitoring your health is a licensed healthcare provider – not an unregulated person offering “care” at a discount.

Also called HSV-2, this virus is not HPV.

HSV-2 can cause genital herpes which generally results in blisters in and around the genital area. The blisters break and become sores that take a week or more to heal. This virus is transmitted through contact between genitals or between mouth and genitals. There’s no cure for herpes, but condom use limits transmission.

Its close cousin, herpes simplex virus type 1, which is also called HSV-1, typically causes blisters (cold sores) on the lips gums, tongue, roof of your mouth, and inside your cheeks.

We use the word typically because sometimes the cousins switch places – HSV-1 causing genital herpes and HSV-2 causing oral herpes. Either way, these viruses do not lead to cervical cancer.

For more information go to www.cdc.gov/std/herpes/STDFact-herpes.htm and www.herpes.com/hsv1-2.html

Each of the virus types that can cause cervical cancer is called high-risk HPV. The HPV test looks for high-risk HPV.

High-risk HPV itself is not cancer. But if high-risk HPV remains in the cervix for years, it can cause changes in healthy cells that lead to cancer.

The full name for this virus is human papillomavirus. (“Papilloma” is pronounced “pap-ah-LO-mah.”) There are over a hundred types of viruses called HPV. Most HPV types can cause warts, some in the genital area – but do not lead to cervical cancer. The types of HPV viruses we are concerned with can lead to cervical cancer. These types are called high-risk HPV.

In 2003 the HPV test was approved by the FDA to be used with the Pap test. When the Pap test is used with the HPV test, together they achieve what scientists call sensitivity reaching 100%.

In 2006 an HPV vaccine was approved by the FDA for girls/women 9 through 26 years of age.

The HPV vaccine helps protect against the two types of HPV that cause approximately 70% of all cervical cancers. (It also protects against two types of HPV that cause genital warts.) However the vaccine doesn’t protect against all types of HPV that can cause cervical cancer. It also doesn’t protect you if you already have the two types of HPV vaccine in your system.

Even if you have the HPV vaccine, you still must be tested like everyone else. For more information go to www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm

This is surgery to remove the uterus (womb). Total hysterectomy removes the uterus and the cervix.

Young women with small tumors may be able to have less invasive surgery that preserves the ability to have children. This procedure is called radical vaginal trachelectomy or RVT. If your healthcare provider says you need a hysterectomy, ask if RVT is appropriate for you.

Even if you have a total hysterectomy you may be able to have your eggs harvested. They can be frozen unfertilized for future insemination. Or they can be inseminated with sperm and the embryos frozen for future use.

A body with an immune disease – also known as autoimmune disease – attacks its own cells. This causes a compromised immune system, which may have difficulty fighting off infections such as an HPV infection.

Diseases such as lupus and HIV/AIDS can compromise the immune system.

This website lists immune diseases and support groups: http://www.dmoz.org/Health/Conditions_and_Diseases/Immune_Disorders/Auto-Immune/

This website discusses HIV/AIDS and the immune system: http://www.cdc.gov/hiv/topics/basic/

Also sometimes referred to as lymph glands, lymph nodes are small rounded pieces of tissue. They are located throughout the body and defend it against infections. If cervical cancer spreads to lymph nodes, your healthcare provider may remove those lymph nodes as part of your surgery.

Metastatic cancer is cancer that has spread from its original location to other parts of the body. Your healthcare provider will consider how to treat the cancer in its original (primary) location and in the one or more places to which it has spread.

For medical diagnoses, negative means good news. A negative HPV test result means no problems were found.

A lab performing a Pap test did not find any cell changes.

The Pap test has been around since the 1940s. It is used to look for cell changes under a microscope. It has helped decrease the number of American women with cervical cancer by about 75%. It can be administered by your healthcare provider alone or with the HPV test.

Your healthcare provider sends collects Pap cells in one of two ways.

• For a Pap smear, your healthcare provider puts cervical cells directly on a glass slide for the lab.
• For a liquid–based Pap, healthcare provider puts cervical cells into a bottle of liquid; the lab then transfers the cells onto a glass slide.

Researchers find that the liquid-based Pap test gives more reliable results.

Within two years of HPV infection, most women get rid of HPV on their own. However, if the virus does not go away, it is called persistent. If a woman 30 years and older has a persistent HPV infection, she must be carefully monitored.

A positive HPV test result means you have an HPV type that can potentially lead to cervical cancer. Keep in mind: this does not necessarily mean you have cervical cancer. It does mean you and your healthcare provider will have to keep a close eye on your cervix.

Radiation therapy (high-energy x-rays) kills cancer cells. The radiation can be delivered using a machine outside the body, or through a radioactive substance placed in the body.

Young women with small tumors may be able to have an RVT, which involves the removal of most or all of the cervix, the tissue around the uterus and part of the vagina. By leaving the uterus, this less invasive surgery preserves a woman’s ability to have children. If your healthcare provider says you need a hysterectomy, ask if RVT is appropriate for you.

Your healthcare provider makes an incision into your body to treat cervical cancer. Though surgery isn’t pain-free, keep in mind that modern medicine has excellent pain control – don’t forget to ask for it.

A woman who agrees to carry and give birth to a child on behalf of a woman who cannot physically have a baby herself. Surrogacy is often through a pre-arranged legal contract. The laws affecting this arrangement are complicated, and different in every state. Be sure to get legal advice.

The testing lab cannot tell whether your Pap is normal or abnormal. (The medical term is ASC-US, shorthand for atypical squamous cells of undetermined significance.) Your cervical cells look like they could be abnormal. This is not an unusual result. And it doesn’t mean the lab did a bad job. It’s just impossible to know at that time.

The womb.

The canal that begins on the outside at the vaginal opening and extends about three to five inches inside, ending at the cervix – which is the neck of the uterus (womb).

A tiny organism smaller than a bacterium. Because a virus must live inside a cell, it invades living cells to keep itself alive and to make more copies of itself. Viruses cause many everyday infections (such as the common cold). They are also responsible for diseases such as HPV.

The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina.