Vulvar cancer is cancer of the labia or skin of a woman's genitals. It is very rare. Having HPV is a risk factor. Get more details here.
Vulva
Image by Vulva by Frede from NounProject.com
Vulvar Cancer
Diagram 1 of 2 showing stage 3A vulval cancer CRUK 496
Diagram 2 of 2 showing stage 3A vulval cancer CRUK 497
Diagram 1 of 2 showing stage 3B vulval cancer CRUK 498
Diagram 2 of 2 showing stage 3B vulval cancer CRUK 499
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Vulval cancer - Stage 3
Interactive by Cancer Research UK uploader
Diagram 1 of 2 showing stage 3A vulval cancer CRUK 496
Diagram 2 of 2 showing stage 3A vulval cancer CRUK 497
Diagram 1 of 2 showing stage 3B vulval cancer CRUK 498
Diagram 2 of 2 showing stage 3B vulval cancer CRUK 499
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Vulval cancer - Stage 3
Interactive by Cancer Research UK uploader
Vulvar Cancer
Vulvar cancer is a rare type of cancer. It forms in a woman's external genitals, called the vulva. The cancer usually grows slowly over several years. First, precancerous cells grow on vulvar skin. This is called vulvar intraepithelial neoplasia (VIN), or dysplasia. Not all VIN cases turn into cancer, but it is best to treat it early.
Often, vulvar cancer doesn't cause symptoms at first. However, see your doctor for testing if you notice
A lump in the vulva
Vulvar itching or tenderness
Bleeding that is not your period
Changes in the vulvar skin, such as color changes or growths that look like a wart or ulcer
You are at greater risk if you've had a human papillomavirus (HPV) infection or have a history of genital warts. Your health care provider diagnoses vulvar cancer with a physical exam and a biopsy. Treatment varies, depending on your overall health and how advanced the cancer is. It might include surgery, radiation therapy, chemotherapy, or biologic therapy. Biologic therapy boosts your body's own ability to fight cancer.
Source: NIH: National Cancer Institute
Additional Materials (3)
What Every Woman Should Know: Vaginal & Vulvar Cancer
Video by Foundation for Women's Cancer/YouTube
What Do I Need to Know About Vaginal Cancer? Ask an Oncologist.
Video by UAMS/YouTube
Not Just Words PSA (:60)
Video by Centers for Disease Control and Prevention (CDC)/YouTube
3:30
What Every Woman Should Know: Vaginal & Vulvar Cancer
Foundation for Women's Cancer/YouTube
2:13
What Do I Need to Know About Vaginal Cancer? Ask an Oncologist.
UAMS/YouTube
1:00
Not Just Words PSA (:60)
Centers for Disease Control and Prevention (CDC)/YouTube
General Info
Drawing of vulvar cancer
Image by Internet Archive Book Images
Drawing of vulvar cancer
Drawing of vulvar cancer
Image by Internet Archive Book Images
General Information About Vulvar Cancer
KEY POINTS
Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.
Having vulvar intraepithelial neoplasia or HPV infection can increase the risk of vulvar cancer.
Signs of vulvar cancer include bleeding or itching in the vulvar area.
Tests that examine the vulva are used to diagnose vulvar cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
Vulvar cancer is a rare disease in which malignant (cancer) cells form in the tissues of the vulva.
Vulvar cancer forms in a woman's external genitalia. The vulva includes:
Inner and outer lips of the vagina.
Clitoris (sensitive tissue between the lips).
Opening of the vagina and its glands.
Mons pubis (the rounded area in front of the pubic bones that becomes covered with hair at puberty).
Perineum (the area between the vulva and the anus).
Anatomy of the vulva. The vulva includes the mons pubis, clitoris, urethral opening, inner and outer lips of the vagina, vaginal opening, and perineum.
Vulvar cancer most often affects the outer vaginal lips. Less often, cancer affects the inner vaginal lips, clitoris, or vaginal glands.
Vulvar cancer usually forms slowly over many years. Abnormal cells can grow on the surface of the vulvar skin for a long time. This condition is called vulvar intraepithelial neoplasia (VIN). Because it is possible for VIN to become vulvar cancer, it is important to get treatment.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
Whether the cancer has spread to nearby areas or other parts of the body.
Whether the cancer has spread to the lymph nodes.
Whether the cancer has just been diagnosed or has recurred (come back).
Source: National Cancer Institute (NCI)
Additional Materials (15)
What is vulvar cancer? | Patient Explainers
Video by Patient/YouTube
Cancer of the Vulva
Video by Robert Miller/YouTube
Vulvar cancer treatment
Video by dooryim/YouTube
Symptoms of vulvar cancer
Video by Legacy Health/YouTube
What Is Vulvar Cancer? - Lynn Kowalski, MD - Gynecologic Oncologist
Video by MountainView Hospital/YouTube
How many types of vulvar cancer are there?
Video by Patient/YouTube
Treating Vulvar Dermatoses at SLUCare Dermatology
Video by SLUCare/YouTube
Vulvar Pain – Mayo Clinic Women’s Health Clinic
Video by Mayo Clinic/YouTube
What is vulvar itch?
Video by Patient/YouTube
What Every Woman Should Know: Vaginal & Vulvar Cancer
Video by Foundation for Women's Cancer/YouTube
Dr. Daniel Donato, What are the symptoms of vulvar cancer? Rose Medical Center
Video by Rose Medical Center/YouTube
How common is vulvar cancer?
Video by Patient/YouTube
Topic 51: Vulvar Neoplasms
Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
Topic 35: Vulvar and Vaginal Disease
Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
Vulvar Pain Vulvodynia Causes, Symptoms, and Treatments Pelvic Rehabilitation Medicine
Video by Pelvic Rehabilitation Medicine/YouTube
1:28
What is vulvar cancer? | Patient Explainers
Patient/YouTube
14:20
Cancer of the Vulva
Robert Miller/YouTube
1:26
Vulvar cancer treatment
dooryim/YouTube
0:24
Symptoms of vulvar cancer
Legacy Health/YouTube
1:08
What Is Vulvar Cancer? - Lynn Kowalski, MD - Gynecologic Oncologist
MountainView Hospital/YouTube
0:29
How many types of vulvar cancer are there?
Patient/YouTube
3:43
Treating Vulvar Dermatoses at SLUCare Dermatology
SLUCare/YouTube
3:26
Vulvar Pain – Mayo Clinic Women’s Health Clinic
Mayo Clinic/YouTube
0:56
What is vulvar itch?
Patient/YouTube
3:30
What Every Woman Should Know: Vaginal & Vulvar Cancer
Foundation for Women's Cancer/YouTube
1:37
Dr. Daniel Donato, What are the symptoms of vulvar cancer? Rose Medical Center
Rose Medical Center/YouTube
0:25
How common is vulvar cancer?
Patient/YouTube
5:00
Topic 51: Vulvar Neoplasms
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
7:04
Topic 35: Vulvar and Vaginal Disease
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
2:13
Vulvar Pain Vulvodynia Causes, Symptoms, and Treatments Pelvic Rehabilitation Medicine
Pelvic Rehabilitation Medicine/YouTube
Risk Factors
Human Papillomavirus (HPV)
Image by TheVisualMD
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted infections.
Image by TheVisualMD
Having Vulvar Intraepithelial Neoplasia or HPV Infection Can Increase the Risk of Vulvar Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for vulvar cancer include the following:
Older age.
Having human papillomavirus (HPV) infection.
Having vulvar intraepithelial neoplasia (VIN).
Having a history of genital warts.
Other possible risk factors include the following:
Having many sexual partners.
Having first sexual intercourse at a young age.
Having a history of abnormal Pap tests (Pap smears).
Source: National Cancer Institute (NCI)
Additional Materials (2)
6 cancer symptoms women shouldn't ignore
Video by MD Anderson Cancer Center/YouTube
How common is vulvar cancer?
Video by Patient/YouTube
1:02
6 cancer symptoms women shouldn't ignore
MD Anderson Cancer Center/YouTube
0:25
How common is vulvar cancer?
Patient/YouTube
Symptoms
Pelvic pain
Image by Sydney Sims/Unsplash
Pelvic pain
Image by Sydney Sims/Unsplash
Signs of Vulvar Cancer Include Bleeding or Itching in the Vulvar Area
Vulvar cancer often does not cause early signs or symptoms. Signs and symptoms may be caused by vulvar cancer or by other conditions. Check with your doctor if you have any of the following:
A lump or growth on the vulva that looks like a wart or ulcer.
Itching in the vulvar area that does not go away.
Bleeding not related to menstruation (periods).
Pain in the vulvar area.
Source: National Cancer Institute (NCI)
Additional Materials (4)
Recognize Vulva Cancer Symptoms
Video by How To DIY & VR Gaming/YouTube
Symptoms of vulvar cancer
Video by Legacy Health/YouTube
Vulvar Pain – Mayo Clinic Women’s Health Clinic
Video by Mayo Clinic/YouTube
Dr. Daniel Donato, What are the symptoms of vulvar cancer? Rose Medical Center
Video by Rose Medical Center/YouTube
3:20
Recognize Vulva Cancer Symptoms
How To DIY & VR Gaming/YouTube
0:24
Symptoms of vulvar cancer
Legacy Health/YouTube
3:26
Vulvar Pain – Mayo Clinic Women’s Health Clinic
Mayo Clinic/YouTube
1:37
Dr. Daniel Donato, What are the symptoms of vulvar cancer? Rose Medical Center
Rose Medical Center/YouTube
Diagnosing
Chair for gynaecological examination
Image by Sciencia58/Wikimedia
Chair for gynaecological examination
Chair for gynaecological examinations with sonography device and screen.
Image by Sciencia58/Wikimedia
Tests That Examine the Vulva Are Used to Diagnose Vulvar Cancer
Tests that examine the vulva are used to diagnose vulvar cancer.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking the vulva for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.
Pap test: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal.
Human papillomavirus (HPV) test: A laboratory test used to check DNA or RNA for certain types of HPV infection. Cells are collected from the vulva and DNA or RNA from the cells is checked to find out if an infection is caused by a type of human papillomavirus that is linked to vulvar cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal vulvar cells.
Biopsy: The removal of cells or tissues from the vulva so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) or a brush and checked under a microscope for signs of disease.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Source: National Cancer Institute (NCI)
Additional Materials (3)
Dr. Doe's Pelvic Exam
Video by sexplanations/YouTube
What to Expect From a Female Pelvic Ultrasound Exam
Video by RAYUS Radiology™/YouTube
A Patient’s Guide to Colposcopy: What to Expect When Having a Colposcopy.
Video by Alberta Health Services/YouTube
5:45
Dr. Doe's Pelvic Exam
sexplanations/YouTube
2:19
What to Expect From a Female Pelvic Ultrasound Exam
RAYUS Radiology™/YouTube
8:20
A Patient’s Guide to Colposcopy: What to Expect When Having a Colposcopy.
Alberta Health Services/YouTube
Pelvic Exam
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
Related conditions
A pelvic exam is a physical exam of the vulva, vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. First, the vulva is checked for redness, swelling, sores, or other abnormalities. A speculum is then inserted into the vagina to widen it so the vagina and cervix can be checked for signs of disease. Cell samples may be taken for a Pap test or HPV test to screen for cervical cancer. The health care provider then inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand to feel for lumps and check the size, shape, and position of the uterus and ovaries. The rectum may also be checked for lumps or abnormal areas.
Pelvic Exam. NCI's Dictionary of Cancer Terms [accessed on Oct 03, 2021]
Pelvic Exam: Preparation, Process, and More. Healthline. [accessed on Oct 03, 2021]
What Is a Pelvic Exam? | Questions About Gynecology Exams. Planned Parenthood. [accessed on Jan 15, 2022]
Pelvic Exam | Michigan Medicine [accessed on Jan 15, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
A cervical screening test - What can you expect?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
How can I deal with the fear of getting a pelvic exam in the doctor's office?
Video by IntermountainMoms/YouTube
Dr. Doe's Pelvic Exam
Video by sexplanations/YouTube
Pelvic Exam Illustration
Line drawing showing pelvic exam procedure.
Image by National Cancer Institute / Unknown Illustrator
Pelvic Exam
Leopold maneuvers
Image by Christian Gerhard Leopold
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
Image by TheVisualMD
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Healthy Cervix
The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Uterus and Ovaries in Ultrasound
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
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This media may include sensitive content
Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Women's Health Checkup
Doctors Examining Pregnant Woman
Image by Israel Defense Forces
2:13
A cervical screening test - What can you expect?
Healthchanneltv / cherishyourhealthtv/YouTube
2:21
How can I deal with the fear of getting a pelvic exam in the doctor's office?
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
A female pelvic ultrasound is a test that uses an ultrasound machine to examine the organs and tissues inside your pelvis, including your cervix, fallopian tubes, ovaries, uterus, vagina, and bladder.
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
Abnormalities in the structure of the ovaries
Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
Ectopic pregnancy (pregnancy that occurs outside of the uterus)
Abnormal bleeding or pelvic pain
Postmenopausal bleeding
Find an intrauterine contraceptive device (IUD)
As part of the work-up for infertility and assisted reproduction techniques
There are two ways to perform a female pelvic ultrasound, which are transabdominal (external, through the abdominal wall) and transvaginal (internal, through the vagina).
Transabdominal pelvic ultrasound
For the transabdominal pelvic ultrasound, you will be asked to unzip your pants, uncover your abdomen, and lie on your back on the medical exam table. Then, a healthcare practitioner will apply a water-based gel on the skin of your lower abdominal area and then place a small probe to visualize your pelvic organs on a screen.
Transvaginal pelvic ultrasound
For the transvaginal pelvic ultrasound, you will be asked to remove your underwear and lie on your back. Then, a healthcare practitioner will apply a water-based gel on a probe that has been previously covered with a plastic/latex sheath, and the probe will be carefully inserted on your vagina. During the procedure, the healthcare practitioner will move the probe a little bit to examine your organs properly.
Either of these procedures usually takes no more than 20 minutes, and there is no need for an anesthetic because they’re painless.
For the transabdominal pelvic ultrasound you must have a full bladder; therefore, you will be asked to drink about 32 ounces of liquid at least 1 hour before the exam.
For the transvaginal pelvic ultrasound your bladder must be empty, so you will be asked to urinate right before the exam.
There are no risks related to a female pelvic ultrasound test.
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
Fibroid tumors
Cysts
Ovarian torsion
Pelvic masses
Pelvic inflammatory disease
Ectopic pregnancy
Miscarriage
Free liquid in the pelvic cavity
Endometrial hyperplasia, which is a thickening of the endometrium
This test can provide information about the location, size, and structure of pelvic masses, but cannot provide a definite diagnosis of cancer or several other conditions.
Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
Pelvic Ultrasound [accessed on Dec 27, 2018]
Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
What to Expect From a Female Pelvic Ultrasound Exam
Video by RAYUS Radiology™/YouTube
2:19
What to Expect From a Female Pelvic Ultrasound Exam
RAYUS Radiology™/YouTube
Pap Smear
Pap Smear
Also called: Papanicolaou Smear, Cervical Smear, Cervical Cytology, Vaginal Cytology, Cervical Screening, Gynecologic Pap Test, Pap Smear
A Pap smear is a routine test that looks for abnormal cells in the cervix (the uppermost portion of the vagina). Finding and treating these cells early can help prevent cervical cancer.
Pap Smear
Also called: Papanicolaou Smear, Cervical Smear, Cervical Cytology, Vaginal Cytology, Cervical Screening, Gynecologic Pap Test, Pap Smear
A Pap smear is a routine test that looks for abnormal cells in the cervix (the uppermost portion of the vagina). Finding and treating these cells early can help prevent cervical cancer.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A negative or normal test result is reported as "Negative for intraepithelial lesion or malignancy". However, a negative report may also note benign findings such as infections or inflammation.
Related conditions
A Pap smear is a test to screen for cervical cancer. If cervical cancer is found and treated early, there is a better chance it can be cured. This type of cancer starts in the cells of the cervix. Your cervix is the lower part of your uterus, the place where a developing baby grows during pregnancy. The cervix opens into your vagina.
Cervical cancer develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes in which abnormal cells begin to appear in the cervical tissue. This is called dysplasia. Over time, if not destroyed or removed, the abnormal cells may become cancer cells. They can grow and spread into other parts of the cervix and the areas around it.
During a Pap smear, your health care provider collects cells from your cervix and sends them to a lab. There, the cells are checked under a microscope for cancer or signs that they are abnormal and may become cancer. Cells that may become cancer are called precancerous cells. Finding and treating precancerous cells can help prevent cervical cancer.
The Pap smear is also a reliable way to find cancer early, when it's easier to treat. A pap smear may also find certain infections or inflammation.
Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique
A Pap smear looks for abnormal changes in cervical cells before they become cancer. Sometimes, the cells collected during a Pap smear are also checked for HPV (human papillomaviruses). HPV is the name of a group of related viruses, some of which can spread through sexual contact. HPV can cause cell changes that may lead to cancer, including in the cervix. Long-lasting infections with high-risk types of HPV cause almost all cervical cancers. So if you have a cervix and are infected with these types of HPV, you have a higher risk of getting cervical cancer.
Pap smears and HPV tests are cervical cancer screening tests that look for cancer before you have any symptoms. Cervical cancer screening can reduce your risk of getting cervical cancer or dying from the disease. Ask your provider which test is right for you or if you should have both a Pap smear and an HPV test.
Your age and health history will help determine how often you should have a Pap smear. If you have a cervix, it's recommended that you have your first Pap smear at age 21.
If you're between ages 21 and 29 and your last Pap test result was normal:
Your provider may say you can wait three years until your next Pap test.
At age 25, you should begin screening with an HPV test and have them every five years through age 65.
If you're between ages 30 and 65 and your last Pap smear result was normal:
Your provider may say you can wait three years until your next Pap smear.
If you also had a normal HPV test result, your provider may say that you can wait five years until your next test.
If you had an HPV test and a Pap smear, called co-testing, and had normal results for both, your provider may say that you can wait five years until your next test.
If you're over age 65, talk with your provider about whether you still need Pap smears. If you've had regular screenings with normal results, they may tell you that you don't need Pap smears anymore.
You don't need cervical cancer screening if you had a total hysterectomy (surgery to remove your uterus and cervix) because of a condition that was not cancer. But if your hysterectomy was related to cervical cancer or precancer, ask your provider whether you need screening.
If you are at higher risk of developing cervical cancer, your provider may recommend screening more often. You may be at higher risk if you:
Had an abnormal HPV test, Pap smear, or cervical biopsy in the recent past.
Have had a diagnosis of cervical cancer.
Have HIV. You may also need screenings after age 65.
Have a weakened immune system.
Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between the years 1940-1971, DES was sometimes prescribed to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it before birth.
If you're under age 21, cervical cancer screening is not recommended. Your risk of cervical cancer is very low. Also, any changes in cervical cells will likely go away on their own.
If you are unsure whether you need a Pap smear, talk with your provider.
During a Pap smear:
You will be asked to undress completely or from the waist down.
You will lie on an exam table with your knees bent and your heels in footrests called stirrups.
Your provider will gently insert a plastic or metal instrument called a speculum into your vagina. This helps to widen your vagina so that your cervix can be seen. This may cause a feeling of cramping or pressure.
Your provider will then use a small, soft brush or swab to collect cells from the cervix. This doesn't usually hurt.
The cell sample is sent to a lab for examination under a microscope.
A Pap smear is often done as part of a pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn't always include a Pap smear. So, when you have a pelvic exam, ask your provider whether you'll have a Pap smear, too.
You should not have a Pap smear while you are having your period because this may affect your results. A good time to have the test is about five days after the last day of your period. For two days before your test, you should not:
Use tampons
Use birth control foam, jelly, or cream
Use other creams or medicines in your vagina
Douche (rinse the vagina with water or other fluid)
Have vaginal sex
You may feel some mild discomfort during a Pap smear and have some very light bleeding afterward, but there are no known risks to having a Pap smear.
A Pap smear test could have the following results:
Normal or "negative" result, which usually means that no abnormal changes were found in your cervix cells. Your provider may tell you that you can wait three years for your next test. If you also had a normal HPV test result, you may be able to wait five years for your next test, depending on your age and medical history.
Unsatisfactory results, which may mean that the lab sample did not have enough cells, or the cells may have been clumped together or hidden by mucus. Your provider may ask you to come in for another test in a few months.
Unclear results, which may mean that your cells look abnormal, but it's unclear if it's due to HPV. Unclear results could also be related to pregnancy, menopause, or an infection. An HPV test may help to find out if unclear results are due to HPV. Your provider will let you know if other tests need to be done.
Abnormal or "positive" result, which usually means that abnormal changes were found in your cervical cells. Most of the time, abnormal results do not mean you have cervical cancer. Minor changes in the cells usually go back to normal on their own. But your provider may recommend a follow-up test to check. More serious cell changes may turn into cancer if they are not removed. Finding and treating these cells early can help prevent cancer from developing.
A Pap smear doesn't diagnose cancer. It's also possible to receive a false-positive result, in which your results appear abnormal, but there are no precancerous or cancerous cells. Or you could have a false-negative, which happens when your results appear normal but there are precancer or cancerous cells.
Talk with your provider to learn what your Pap smear results mean. If they are concerned about your results, they may perform a colposcopy. This is an exam that uses a special magnifying instrument to look closely at your cervix to help diagnose or rule out cervical cancer.
Pap Smear: MedlinePlus Medical Test [accessed on Sep 25, 2024]
Definition of atypical squamous cells of undetermined significance - NCI Dictionary of Cancer Terms - National Cancer Institute [accessed on Dec 20, 2018]
192005: Gynecologic Pap Test, Liquid-based Preparation | LabCorp [accessed on Dec 28, 2018]
https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results [accessed on Dec 28, 2018]
Understanding Abnormal Cervical Cancer Screening Results [accessed on Dec 28, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (19)
A cervical screening test - What can you expect?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
Cervical Dysplasia (Gynecology - Pap Smear)
Video by Med Twice/YouTube
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Pap Smear showing Chlamydia
Human pap smear showing Chlamydia in the vacuoles at 500x and stained with H&E.
Image by Dr. Lance Liotta Laboratory / Unknown Photographer
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Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Pap Test: Human Papillomavirus (HPV)
The human papillomavirus (HPV) is responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact. It may cause genital warts and can lead to cervical cancer as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually. However, only a small subset of these strains are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. HPV vaccines are available for both men and women to prevent infection by some of the more dangerous virus strains associated with the development of cervical cancer.
Image by TheVisualMD
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HPV E6 E7 mRNA and Pap Tests
HPV E6 E7 mRNA and Pap Tests: Pap tests (ie, cervical cytology) are the most common way to screen for cervical cancer and routine Pap testing is credited with widely reducing the incidence of cervical cancer since the tests implementation. Pap tests are, however, limited by their relatively low sensitivity and specificity.Studies suggest that testing for high-risk HPV DNA is a more sensitive method of determining a woman`s risk of developing cervical cancer. Though current high-risk HPV DNA testing methods provide adequate sensitivity, specificity is lacking, which can lead to false-positive results and unnecessary invasive procedures such as colposcopy and biopsy. Its important for every woman to talk to her doctor about what tests are right for her.
Image by TheVisualMD
Pap smears vs HPV testing and cervical cancer detection
Video by Pathology Tests Explained/YouTube
Human Papillomavirus (HPV)
Risk Factors for Cancer: Virus : Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid the virus responsible for genital HPV infection one of the most common sexually transmitted infections. Often asymptomatic genital HPV infection is spread through genital skin-to-skin contact causes genital warts and can lead to cervical cancer as well as some cases of anal rectal and penile cancer. There are more than 100 strains of HPV and more than 40 of these are transmitted sexually; however only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. Consistent condom use has been shown to reduce the risk of HPV infection by as much as 70% but condoms do not protect all anatomy vulnerable to the virus. Vaccines that can prevent initial infection of some of the more dangerous strains are widely available.
Image by TheVisualMD
Pap Smear
A female Caucasian scientist examining pap smears under the microscope.
Image by National Cancer Institute / Bill Branson (Photographer)
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Pap Smear Laser
One of the many uses for the laser in medical research is as a light source to detect premalignant and malignant cells in a Pap smear. Gynecologic cells passing in a stream through the laser beam where each cell is analyzed. Abnormal-appearing cells can be sorted from the rest of the cells and later examined by a pathologist for evidence of cancer.
Image by National Cancer Institute / Unknown Photographer
Endometrial Cancer
Endometrial cancer is the most commonly diagnosed gynecological cancer. Women with clear cell endometrial cancer, a rare type of endometrial cancer, generally have poorer clinical outcomes
Image by Darryl Leja, NHGRI
Advanced Cancer Cell Growth in Cervix
Three-dimensional visualization reconstructed from scanned human data. Superiolateral view of cross-section of advanced cancerous cell growth of cervix. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 3 of 3.
Image by TheVisualMD
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Healthy Cervix
The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Studying Cells
These uterine cervix cells, viewed through a light microscope, were obtained from a Pap smear. Normal cells are on the left. The cells on the right are infected with human papillomavirus (HPV). Notice that the infected cells are larger; also, two of these cells each have two nuclei instead of one, the normal number. (credit: modification of work by Ed Uthman, MD; scale-bar data from Matt Russell)
Image by CNX Openstax
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
Human Papillomavirus (HPV)
Anterior view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
Normal Cell Growth in Cervix
Three-dimensional visualization reconstructed from scanned human data. Superiolateral view of cross-section of healthy cervical cells. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 1 of 3.
Image by TheVisualMD
Uterus and Cervix Sagittal Section
Medical visualization of a lateral cross-section of a healthy cervix, as well as the uterus and vagina. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 1 of 2.
Image by TheVisualMD
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted infections.
Image by TheVisualMD
2:13
A cervical screening test - What can you expect?
Healthchanneltv / cherishyourhealthtv/YouTube
6:01
Cervical Dysplasia (Gynecology - Pap Smear)
Med Twice/YouTube
Sensitive content
This media may include sensitive content
Pap Smear showing Chlamydia
Dr. Lance Liotta Laboratory / Unknown Photographer
Sensitive content
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Pap Test: Pap Smear (Pap Test)
TheVisualMD
Pap Test: Human Papillomavirus (HPV)
TheVisualMD
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This media may include sensitive content
HPV E6 E7 mRNA and Pap Tests
TheVisualMD
3:40
Pap smears vs HPV testing and cervical cancer detection
Pathology Tests Explained/YouTube
Human Papillomavirus (HPV)
TheVisualMD
Pap Smear
National Cancer Institute / Bill Branson (Photographer)
Sensitive content
This media may include sensitive content
Pap Smear Laser
National Cancer Institute / Unknown Photographer
Endometrial Cancer
Darryl Leja, NHGRI
Advanced Cancer Cell Growth in Cervix
TheVisualMD
Sensitive content
This media may include sensitive content
Healthy Cervix
TheVisualMD
Studying Cells
CNX Openstax
Human Papillomavirus (HPV)
TheVisualMD
Human Papillomavirus (HPV)
TheVisualMD
Normal Cell Growth in Cervix
TheVisualMD
Uterus and Cervix Sagittal Section
TheVisualMD
Human Papillomavirus (HPV)
TheVisualMD
Human Papillomavirus (HPV) Test
Human Papillomavirus (HPV) Test
Also called: HPV, HPV DNA, High-risk HPV, HPV Genotyping
An HPV test looks for high-risk HPV (human papillomavirus) infections in women. HPV is the most common sexually transmitted disease. Most infections aren't serious. But some high-risk HPV infections can cause cervical and other types of cancer.
Human Papillomavirus (HPV) Test
Also called: HPV, HPV DNA, High-risk HPV, HPV Genotyping
An HPV test looks for high-risk HPV (human papillomavirus) infections in women. HPV is the most common sexually transmitted disease. Most infections aren't serious. But some high-risk HPV infections can cause cervical and other types of cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative HPV test means that no "high-risk" HPV strains were found in the tissue sample. It is recommended that women age 30 and older have an HPV test with their pelvic exam and Pap test. If both tests are negative, they should be repeated every 5 years.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result indicates the absence of HPV DNA of the targeted genotypes (HPV-16 and HPV-18). Women with a negative HPV-16 and HPV-18 result, negative Pap smear, but positive high-risk HPV test result should consider repeat testing by both Pap smear and HPV testing in 12 months.
Related conditions
HPV stands for human papillomavirus. There are many types of HPVs. Some of them are spread through close skin-to-skin touching during sex with a person who has the virus. These HPVs are the most common cause of sexually transmitted diseases (STD).
Certain types of HPV cause genital warts. Other types, called "high-risk HPV," can cause cancer, especially cancer of the cervix. The cervix is the lower part of the uterus where a baby grows during pregnancy. Most cervical cancers are caused by HPV. That means if you have a cervix and are infected with certain types of HPV, you have a higher risk of getting cervical cancer.
HPV tests use a sample of cells from your cervix to look for signs of infection with high-risk HPVs that can lead to cervical cancer. Knowing whether you have HPV helps your healthcare provider understand your risk for developing cervical cancer. If you have an HPV infection, you can discuss whether you need other tests and how often you should be checked for cervical cancer.
Usually, your immune system gets rid of an HPV infection naturally within two years without causing any health problems. But in certain cases, high-risk HPV infections can stay in the body for many years, even decades. These long-lasting infections can lead to cancer.
The test is used to check a sample of cervical cells for signs of infection with high-risk HPV that can lead to cervical cancer. The test is often done at the same time as a Pap smear, which is a test that checks cervical cells for abnormal changes caused by HPV. When an HPV test and a Pap smear are done at the same time, it's called an HPV/Pap cotest.
An HPV test may also be used to make treatment decisions after a diagnosis of oropharyngeal cancer. This cancer grows in the back of the throat, including the tonsils and the base of the tongue. It is mostly caused by HPV. Oropharyngeal cancer from HPV has its own treatment and usually has a better chance of recovery than other throat cancers.
You may need an HPV test to screen for cervical cancer if you:
Had an abnormal result on a Pap smear. An HPV test can show whether HPV caused the abnormal changes in your cervical cells.
Are age 30 through 65. An HPV test alone or an HPV/Pap cotest is recommended every five years as long as you have had normal test results.
If you are between ages 21 and 29, you should have a Pap smear every three years. But you don't need HPV testing if your Pap smear results are normal. While HPV infections are common in this age group, they usually clear up on their own within a year or two without causing any problems. Some medical experts recommend starting HPV testing at age 25 and getting tested every 5 years if your last test was normal.
If you have a high risk for developing cervical cancer, you may need to get tested more often. Your risk may be higher if you:
Had an abnormal HPV test, Pap smear, or cervical biopsy in the recent past
Have HIV
Have a weakened immune system
Have had cervical cancer
Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between 1940-1971, DES was sometimes prescribed to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it before birth.
Ask your provider which cervical cancer screening test is right for you and how often you should be tested.
If you have been diagnosed with oropharyngeal cancer, you may also need an HPV test of your throat, tonsils, or tongue to find out which treatment you should have.
If you're getting an HPV test to screen for cervical cancer, you will lie on an exam table. Your provider will use a plastic or metal instrument called a speculum to widen the vagina, so the cervix can be seen. Your provider will then use a small, soft brush or swab to collect cells from the cervix. The cell sample is sent to a lab for testing.
HPV testing is often done as part of a routine pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn't always include an HPV test. So, when you have a pelvic exam, ask your provider whether you'll have and HPV test, too.
At-home tests to screen for cervical HPV are available. These kits provide a special swab so you can collect a sample of cells from your cervix and vagina to send to a lab. Talk with your provider if you are considering at-home HPV testing.
If you have oropharyngeal cancer, you probably won't need another test to find out whether HPV caused your cancer. That's because oropharyngeal cancer is usually diagnosed by examining a sample of throat tissue that's removed during a biopsy. The tissue sample is usually checked for HPV, too.
You should not have the test while you are having your period. For two days before your test, you should not:
Use tampons
Use birth control foam, jelly, or cream
Use other creams or medicines in the vagina
Douche (rinse the vagina with water or other fluid)
Have vaginal sex
For an at-home test, be sure to read all the instructions before you collect your sample.
You may feel some mild discomfort when the cervical cells are collected. Afterward, you may have some very light bleeding. But there are no known risks to an HPV test.
Negative/Normal HPV test results mean that high-risk HPV was not found in your sample. Your provider will let you know when you should be tested again.
Positive/Abnormal HPV test results mean that signs of high-risk HPV were found. Some HPV tests also show whether HPV16 or HPV18 was found. These types of HPV are the most common cause of cervical cancer.
A positive test result does not mean you have cancer or will get cancer. It does mean that you have an HPV infection that increases your risk for getting cervical cancer in the future.
There's no treatment to get rid of an HPV infection. So, the next steps will depend on your risk for developing cervical cancer. To estimate your risk, your provider will consider past test results, your age, and other health conditions you have or have had.
Your provider may suggest other tests to check your cervical cells for abnormal changes. You may also need more frequent HPV tests or HPV/Pap cotests.
The HPV vaccine is a safe, effective way to protect yourself from HPV infections that can cause cancer and genital warts. The vaccine could prevent many of the cancers that HPV causes, including cancer of the cervix, vagina, throat, anus, and penis.
The vaccine works best when it's given before a person has any exposure to the virus. That's why it's recommended for children before they become sexually active.
The U.S. Centers for Disease Control and Prevention (CDC) recommends that 11 to 12-year-olds have two shots of HPV vaccine 6 to 12 months apart. But the vaccine can be given as early as age 9. Ask your child's provider about when to vaccinate your child against HPV.
Teens and young adults who get their first HPV shot between ages 15 and 26 need to have 3 doses. If you're over 26 and haven't been vaccinated, talk with your provider about the possible benefits of vaccination.
Human Papillomavirus (HPV) Test: MedlinePlus Lab Test Information [accessed on Aug 08, 2023]
HPV DNA test: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
500306: Human Papillomavirus (HPV) High- and Low-risk... | LabCorp [accessed on Jan 08, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
This browser does not support the video element.
Pap & HPV Testing
HPV, the Human Papillomavirus, is a sexually transmitted virus which 8 out of 10 women get by the time they are 50 years old. Usually there are no symptoms and it often goes away on its own. However, when an undetected HPV infection lasts for years, it can cause abnormal cell growth in the cervix, which can sometimes lead to cervical cancer. Screening often involves two tests, a Pap test and an HPV test. A Pap test detects abnormal cell growth and can also tell if infections like herpes and yeast are present. An HPV test screens for high-risk HPV infections that are associated with abnormal cell growth. Co-testing refers to when Pap and HPV tests are collected at the same time and can be an important part of protecting your health.
Video by TheVisualMD
Cervical Cancer - Treatment Options by Stage
Location of cervical cancer and an example of normal and abnormal cells
Image by Blausen Medical Communications, Inc.
Human Papillomavirus (HPV)
Anterior view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
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Freezing of Abnormal Tissue in the Cervix
Medical visualization of an anterior view of pre-cancerous cells on the cervix being frozen via cryotherapy. During cryosurgery, probes deliver liquid nitrogen at a temperature of -50 degrees Celsius to the surface of the cervix to freeze and destroy abnormal cervical tissue. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes.
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Uterus and Cervix Sagittal Section
Medical visualization of a lateral cross-section of a healthy cervix, as well as the uterus and vagina. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 1 of 2.
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Cervix Infected with Cancer
Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted (half of all sexually active men and women are infected with HPV at some point in their lives). Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. More than a dozen HPV types are considered \"high risk\" for cervical cancer, two of them are responsible for 70% of cervical cancers; genetic and environmental risk factors also play roles. The human papillomavirus (HPV) test is like a Pap test in that it involves the collection of cells from the cervix for analysis; the cell sample is taken with a special swab or brush during a pelvic examination. But while a Pap test is designed to spot abnormal cells, which often indicate an HPV infection, it cannot distinguish among different HPV types. An HPV test uses DNA techniques to determine whether an HPV infection has been caused by one of the viral types that lead to an increased risk of cervical cancer.
Image by TheVisualMD
HPV, Cancer Cells
Human papillomavirus (HPV) is a large group of related viruses that infect skin and mucous membranes; there are 30-40 types that are transmitted sexually. More than a dozen HPV types are considered high risk for cervical cancer, but just two of these types are responsible for 70% of cervical cancers. It isn't clear how HPV triggers cancer; evidence of the virus is found in nearly all cases, but most women infected with HPV never develop cervical cancer. Genetic and environmental risk factors also play roles
Image by TheVisualMD
2:41
Pap & HPV Testing
TheVisualMD
Cervical Cancer - Treatment Options by Stage
Blausen Medical Communications, Inc.
Human Papillomavirus (HPV)
TheVisualMD
Human Papillomavirus (HPV)
TheVisualMD
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Freezing of Abnormal Tissue in the Cervix
TheVisualMD
Uterus and Cervix Sagittal Section
TheVisualMD
Cervix Infected with Cancer
TheVisualMD
HPV, Cancer Cells
TheVisualMD
Colposcopy
Colposcopy
Also called: Colposcopy
A colposcopy allows a provider to get a close-up view of a woman's cervix, vagina, and vulva. It uses a magnifying device placed near, but not inside, the vagina. If abnormal cells are found, a biopsy may be performed.
Colposcopy
Also called: Colposcopy
A colposcopy allows a provider to get a close-up view of a woman's cervix, vagina, and vulva. It uses a magnifying device placed near, but not inside, the vagina. If abnormal cells are found, a biopsy may be performed.
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Your result is Negative.
Negative colposcopy results are normal and indicate that no abnormal changes were found.
Related conditions
A colposcopy is a procedure to examine your cervix, vagina, and vulva:
The vagina connects your womb (uterus) and cervix to the outside of your body.
The cervix is the lower part of your uterus (the uterus is the place where a baby grows during pregnancy).
The vulva includes your genital parts that are outside your body.
During the procedure, your health care provider will be looking for abnormal cells, which could be cancer or precancer. Precancer means that the cells could turn into cancer over time.
To do the procedure, your provider will use a lighted, magnifying device called a colposcope. They will place the device at the opening of your vagina. The device magnifies the normal view, allowing your provider to see problems that can't be seen by the eyes alone.
If your provider sees a problem, they may take a tissue sample for testing (biopsy). The sample is most often taken from the cervix. This procedure is known as a cervical biopsy. Biopsies may also be taken from the vagina or vulva. The results of the biopsy will show if you have cells that are cancer or precancer.
Other names: colposcopy with directed biopsy
A colposcopy is most often used to find abnormal cells in the cervix, vagina, or vulva. It may also be used to:
Check for genital warts, which may be a sign of an HPV (human papillomavirus) infection. Having HPV may put you at higher risk for developing cervical, vaginal, or vulvar cancer.
Look for noncancerous growths called polyps.
Check for irritation or inflammation of the cervix.
Check for the cause of abnormal vaginal bleeding or vulvar itching.
If you've already been diagnosed and treated for HPV, the test may be used to monitor cell changes in the cervix. Sometimes, abnormal cells return after treatment.
You may need this test if you had abnormal results on a Pap smear. A Pap smear is a test that involves collecting a sample of cells from the cervix. It can show if there are abnormal cells but can't provide a diagnosis. A colposcopy provides a more detailed look at the cells. It may help your provider confirm a diagnosis and/or find other potential problems. It could allow your provider to find precancer cells early enough that they can be treated and might not turn into cancer.
You may also need this test if you have:
Been diagnosed with HPV
Abnormal areas on your cervix (which were seen during a routine pelvic exam)
Bleeding after sex
A colposcopy may be done by your primary care provider or a gynecologist, a doctor who specializes in diagnosing and treating diseases of the female reproductive system. The test is usually done in the provider's office and takes 10 to 20 minutes. If the provider finds abnormal tissue, you may also get a biopsy. which may take about 10 minutes longer.
During a colposcopy:
You will remove your clothing and put on a hospital gown.
You will lie on your back on an exam table with your feet in stirrups.
Your provider will insert an instrument called a speculum into your vagina. A speculum is the same instrument used in a Pap smear. It is used to spread open your vaginal walls so that your cervix is visible.
Your provider will place the colposcope outside your vagina.
Your provider will shine a light into your vagina and look through the colposcope, which provides a magnified view of the cervix, vagina, and vulva.
Your provider will gently swab your cervix and vagina with a vinegar or iodine solution. The solution makes abnormal tissues easier to see.
If any areas of tissue look abnormal, your provider may perform a cervical, vaginal, or vulvar biopsy.
During a biopsy:
A vaginal biopsy may cause mild to moderate pain, and your provider may recommend you take an over-the-counter pain reliever before the procedure or give you medicine to numb the area.
Once the area is numb, your provider will use a small tool to remove a tissue sample for testing. Sometimes, many samples are taken.
Your provider may also do a procedure called an endocervical curettage (ECC). This procedure involves taking a tissue sample from the inside of the opening of the cervix. This area can't be seen during a colposcopy. An ECC is done with a special tool called a curette. You may feel a pinch or cramp as the tissue is removed.
Your provider may apply a topical medicine to the biopsy site to treat any bleeding you may have.
After a biopsy, you should not douche, use tampons, or have sex for a week after your procedure or for as long as your provider advises.
Do not douche, use tampons or vaginal medicines, or have any kind of vaginal penetration for 48 hours before the test. Also, it's best to schedule your colposcopy when you are not having your menstrual period. Your provider may recommend taking an over-the-counter pain reliever before your appointment.
Tell your provider if you are pregnant or think you may be pregnant. Colposcopy is generally safe during pregnancy, but being pregnant raises your risk of bleeding after a biopsy.
There is very little risk to having a colposcopy. You may have some discomfort when the speculum is inserted into the vagina, and the vinegar or iodine solution may sting, tingle, or burn.
A biopsy is also a safe procedure. You may feel a pinch or some pain when the tissue sample is taken. After the procedure, you may be sore for a day or two. You may have some cramping and slight bleeding. It's normal to have a little bleeding and discharge for up to a week after the biopsy.
Serious complications from a biopsy are rare, but call your provider if you have any of the following symptoms:
Heavy bleeding
Abdominal (belly) pain
Signs of infection, such as fever, chills, and/or bad smelling vaginal discharge
During your colposcopy, your provider may find one or more of the following conditions:
Genital warts
Polyps
Swelling or irritation of the cervix
Abnormal tissue
If your provider also performed a biopsy, your results may show you have:
Precancerous cells in the cervix, vagina, or vulva
An HPV infection
Cancer of the cervix, vagina, or vulva
If your biopsy results were normal, it's unlikely that you have cells in your cervix, vagina, or vulva that are at risk for turning into cancer. But that can change. So, your provider may want to monitor you for cell changes with more frequent Pap smears and/or additional colposcopies.
If you have questions about your results, talk to your provider.
If your results show that you have precancerous cells, you may need to have a procedure to remove them. This may prevent them from developing into cancer.
If your results show that you have cancer, you may be referred to a gynecologic oncologist. This is a provider who specializes in treating cancers of the female reproductive system.
Colposcopy - NHS [accessed on Dec 27, 2018]
What Is A Colposcopy? - When to See a Doctor | familydoctor.org [accessed on Dec 27, 2018]
Colposcopy: What You Need to Know | One Medical [accessed on Dec 27, 2018]
Colposcopy & Cervical Biopsy: Purpose, Procedure, Results & HPV [accessed on Jan 03, 2019]
Colposcopy - Mayo Clinic [accessed on Jan 03, 2019]
Colposcopic evaluation of men with genital warts. - PubMed - NCBI [accessed on Jan 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (11)
Colposcopy
Image of Colposcope
Image by S. Kellam
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HPV E6 E7 mRNA and Pap Tests
HPV E6 E7 mRNA and Pap Tests: Pap tests (ie, cervical cytology) are the most common way to screen for cervical cancer and routine Pap testing is credited with widely reducing the incidence of cervical cancer since the tests implementation. Pap tests are, however, limited by their relatively low sensitivity and specificity.Studies suggest that testing for high-risk HPV DNA is a more sensitive method of determining a woman`s risk of developing cervical cancer. Though current high-risk HPV DNA testing methods provide adequate sensitivity, specificity is lacking, which can lead to false-positive results and unnecessary invasive procedures such as colposcopy and biopsy. Its important for every woman to talk to her doctor about what tests are right for her.
Image by TheVisualMD
Cervical Correlation, ThinPrep Pap
19-year-old woman with no previous Paps in house. I called it ASC-US based on this single group on ThinPrep (1000X). The rest of the slide was negative, even in retrospect. The case reflexed to HPV by Hybrid Capture, which was positive for high-risk HPV. Colposcopy was done.
Image by Ed Uthman
Endoscopy
Instruments used in endoscopy. They are highlighted in an otherwise dark setting and lying on a textured cloth. Flexible fibers, a small brush and a third instrument. The fibers transmit high intensity light through the endoscope shown. The brushes are used to take biopsies.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Diethylstilbestrol (DES) Cervix
A Metaplastic squamous epithelium that is glycogen poor (top), adjacent to normal squamous epithelium that is glycogen rich (bottom). The corresponding regions would fail to stain with iodine (top) or would take up the stain (bottom) . The squamous pegs in the lamina propria represent glands replaced entirely by metaplastic squamous epithelium (H&E, x45). The lower half of the photograph illustrates the junction of metaplastic squamous epithelium (left) adjacent to normal squamous epithelium (right). The hyperkeratosis on the left would appear as leukoplakia on colposcopy (H&E, x 250).
Image by National Cancer Institute / Unknown Photographer
Diethylstilbestrol (DES) Cervix
Metaplastic squamous adjacent to normal squamous apithelium that is glycogen rich. The squamous pegs in the lamina propria represent glands replaced entirely by metaplastic squamous epithelium (H&E, x45). This of the photograph illustrates the junction of metaplastic squamous epithelium (left) adjacent to normal squamous epithelium (right). The hyperkeratosis on the left would appear as leukoplakia on colposcopy (H&E, x 250).
Image by National Cancer Institute / Unknown Photographer
NHS Cervical Cancer Screening Module 3
Video by ASKVisualScience/YouTube
What is Cervical dysplasia?
Video by HealthFeed Network/YouTube
NHS Cervical Cancer Screening Module 1
Video by ASKVisualScience/YouTube
NHS Cervical Cancer Screening Module 2
Video by ASKVisualScience/YouTube
Cervical Cancer Screening Module 4
Video by ASKVisualScience/YouTube
Colposcopy
S. Kellam
Sensitive content
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HPV E6 E7 mRNA and Pap Tests
TheVisualMD
Cervical Correlation, ThinPrep Pap
Ed Uthman
Endoscopy
National Cancer Institute / Linda Bartlett (Photographer)
Diethylstilbestrol (DES) Cervix
National Cancer Institute / Unknown Photographer
Diethylstilbestrol (DES) Cervix
National Cancer Institute / Unknown Photographer
2:11
NHS Cervical Cancer Screening Module 3
ASKVisualScience/YouTube
1:35
What is Cervical dysplasia?
HealthFeed Network/YouTube
1:33
NHS Cervical Cancer Screening Module 1
ASKVisualScience/YouTube
1:45
NHS Cervical Cancer Screening Module 2
ASKVisualScience/YouTube
1:26
Cervical Cancer Screening Module 4
ASKVisualScience/YouTube
Staging
Diagram showing stage 1A and 1B cancer of the vulva
Diagram showing stage 2 cancer of the vulva
Diagram showing stage 3 cancer of the vulva
Diagram showing stage 4A cancer of the vulva
Diagram showing stage 4B cancer of the vulva
1
2
3
4
5
Stages of Vulvar Cancer
Interactive by Cancer Research UK / Wikimedia Commons
Diagram showing stage 1A and 1B cancer of the vulva
Diagram showing stage 2 cancer of the vulva
Diagram showing stage 3 cancer of the vulva
Diagram showing stage 4A cancer of the vulva
Diagram showing stage 4B cancer of the vulva
1
2
3
4
5
Stages of Vulvar Cancer
Diagram showing stages 1A, 1B, 2, 3, 4A, and 4B cancer of the vulva
Interactive by Cancer Research UK / Wikimedia Commons
Stages of Vulvar Cancer
After vulvar cancer has been diagnosed, tests are done to find out if cancer cells have spread within the vulva or to other parts of the body.
The process used to find out if cancer has spread within the vulva or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
Cystoscopy: A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a for signs of cancer.
Proctoscopy: A procedure to look inside the rectum and anus to check for abnormal areas, using a proctoscope. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the rectum and anus. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Chest x-ray: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. To stage vulvar cancer, x-rays may be taken of the organs and bones inside the chest.
Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer has spread to these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters and bladder, x-rays are taken to see if there are any blockages. This procedure is also called intravenous urography.
Biopsy: The removal of cells or tissues from the bladder or rectum so they can be viewed under a microscope by a pathologist to check for signs of cancer, if it is suspected that cancer has spread there.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if vulvar cancer spreads to the lung, the cancer cells in the lung are actually vulvar cancer cells. The disease is metastatic vulvar cancer, not lung cancer.
In vulvar intraepithelial neoplasia (VIN), abnormal cells are found on the surface of the vulvar skin.
These abnormal cells are not cancer. Vulvar intraepithelial neoplasia (VIN) may become cancer and spread into nearby tissue. VIN is sometimes called stage 0 or carcinoma in situ.
The following stages are used for vulvar cancer:
Stage I
In stage I, cancer has formed. The tumor is found only in the vulva. Stage I is divided into stages IA and IB.
Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).
In stage IA, the tumor is 2 centimeters or smaller and has spread 1 millimeter or less into the tissue of the vulva or perineum. Cancer has not spread to the lymph nodes.
In stage IB, the tumor is larger than 2 centimeters or has spread more than 1 millimeter into the tissue of the vulva or perineum. Cancer has not spread to the lymph nodes.Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.
Stage II
In stage II, the tumor is any size and has spread to the lower one-third of the urethra, the lower one-third of the vagina, or the lower one-third of the anus. Cancer has not spread to the lymph nodes.
Stage III
In stage III, the tumor is any size and has spread to the upper two-thirds of the urethra, the upper two-thirds of the vagina, the inner lining of the bladder or rectum, or to any number of lymph nodes. Stage III is divided into stages IIIA, IIIB, and IIIC.
In stage IIIA, cancer is found in lymph nodes in the groin that are not larger than 5 millimeters.
In stage IIIB, cancer is found in lymph nodes in the groin that are larger than 5 millimeters.
In stage IIIC, cancer is found in lymph nodes in the groin and has extended through the outer covering of the lymph nodes.
Stage IV
In stage IV, the tumor is any size and has become attached to the bone, or cancer has spread to lymph nodes that are not movable or have become ulcerated, or there is distant spread. Stage IV is divided into stages IVA and IVB.
In stage IVA, the cancer is attached to the pelvic bone or has spread to lymph nodes in the groin that are not movable or have become ulcerated.
In stage IVB, the cancer has spread beyond the pelvis to distant parts of the body.
Vulvar cancer can recur (come back) after it has been treated.
The cancer may come back in the vulva or in other parts of the body.
Source: National Cancer Institute (NCI)
Additional Materials (1)
New FIGO staging in vulval and cervical cancer
Video by ecancer/YouTube
5:02
New FIGO staging in vulval and cervical cancer
ecancer/YouTube
Cystoscopy
Cystoscopy
Also called: Bladder Endoscopy, Cystoscopy
A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.
Cystoscopy
Also called: Bladder Endoscopy, Cystoscopy
A cystoscopy is a procedure to look inside the urethra and bladder using a thin camera called a cystoscope. The test can help find problems with the urinary tract, including early signs of cancer, infection, narrowing, blockage, or bleeding.
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Your result is Normal.
The bladder wall should look smooth. The bladder should be of normal size, shape, and position. There should be no blockages, growths, or stones.
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Cystoscopy uses a cystoscope to look inside the urethra and bladder. A cystoscope is a long, thin optical instrument with an eyepiece at one end, a rigid or flexible tube in the middle, and a tiny lens and light at the other end of the tube. By looking through the cystoscope, the urologist can see detailed images of the lining of the urethra and bladder. The urethra and bladder are part of the urinary tract.
A urologist performs a cystoscopy to find the cause of urinary tract problems such as
Frequent urinary tract infections (UTIs)
Hematuria—blood in the urine
Urinary frequency—urination eight or more times a day
Urinary urgency—the inability to delay urination
Urinary retention—the inability to empty the bladder completely
Urinary incontinence—the accidental loss of urine
Pain or burning before, during, or after urination
Trouble starting urination, completing urination, or both
Abnormal cells, such as cancer cells, found in a urine sample
During a cystoscopy, a urologist can see
Stones—solid pieces of material in the bladder that may have formed in the kidneys or in the bladder when substances that are normally in the urine become highly concentrated.
Abnormal tissue, polyps, tumors, or cancer in the urethra or bladder.
Stricture, a narrowing of the urethra. Stricture can be a sign of an enlarged prostate in men or of scar tissue in the urethra.
In many cases, a patient does not need special preparations for a cystoscopy. A health care provider may ask the patient to drink plenty of liquids before the procedure, as well as urinate immediately before the procedure.
A urologist performs a cystoscopy or ureteroscopy during an office visit or in an outpatient center or a hospital. For some patients, the urologist will apply an anesthetic gel around the urethral opening or inject a local anesthetic into the urethra.
After the anesthetic has taken effect, the urologist gently inserts the tip of the cystoscope into the urethra and slowly glides it through the urethra and into the bladder. A sterile liquid—water or salt water, called saline—flows through the cystoscope to slowly fill the bladder and stretch it so the urologist has a better view of the bladder wall. As the bladder fills with liquid, the patient may feel some discomfort and the urge to urinate. The urologist may remove some of the liquid from the bladder during the procedure. As soon as the procedure is over, the urologist may remove the liquid from the bladder or the patient may empty the bladder.
When a urologist performs a cystoscopy to make a diagnosis, both procedures—including preparation—take 15 to 30 minutes. The time may be longer if the urologist removes a stone in the bladder or a ureter or if he or she performs a biopsy.
After a cystoscopy or ureteroscopy, a patient may
Have a mild burning feeling when urinating
See small amounts of blood in the urine
Have mild discomfort in the bladder area or kidney area when urinating
Need to urinate more frequently or urgently
These problems should not last more than 24 hours. The patient should tell a health care provider right away if bleeding or pain is severe or if problems last more than a day.
The health care provider may recommend that the patient
Drink 16 ounces of water each hour for 2 hours after the procedure
Take a warm bath to relieve the burning feeling
Hold a warm, damp washcloth over the urethral opening to relieve discomfort
Take an over-the-counter pain reliever
The health care provider may prescribe an antibiotic to take for 1 or 2 days to prevent an infection. A patient should report any signs of infection—including severe pain, chills, or fever—right away to the health care provider.
Most patients go home the same day as the procedure. Recovery depends on the type of anesthesia. A patient who receives only a local anesthetic can go home immediately. A patient who receives general anesthesia may have to wait 1 to 4 hours before going home. A health care provider usually asks the patient to urinate before leaving. In some cases, the patient may need to stay overnight in the hospital. A health care provider will provide discharge instructions for rest, driving, and physical activities after the procedure.
The risks of cystoscopy and ureteroscopy include
UTIs
Abnormal bleeding
Abdominal pain
A burning feeling or pain during urination
Injury to the urethra, bladder, or ureters
Urethral narrowing due to scar tissue formation
The inability to urinate due to swelling of surrounding tissues
Complications from anesthesia
Seek immediate medical care
A patient who has any of the following symptoms after a cystoscopy or ureteroscopy should call or see a health care provider right away:
The inability to urinate and the feeling of a full bladder
Burning or painful urination that lasts more than 2 days
Bright red urine or blood clots in the urine
A fever, with or without chills
Severe discomfort
Cystoscopy & Ureteroscopy | NIDDK [accessed on Jan 08, 2019]
Cystoscopy: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
Cystoscopy for Women - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 08, 2019]
Cystoscopy - NHS [accessed on Jan 08, 2019]
What is Cystoscopy? - Urology Care Foundation [accessed on Jan 08, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
How is a Urinary Tract Infection (UTI) Diagnosed?
Diagram showing a cystoscopy for a man and a woman.
Image by Cancer Research UK / Wikimedia Commons
X-ray of urinary bladder filled with contrast media.
Image by Lucien Monfils
Drawing of cystoscope in the bladder
None
Image by NIDDK Image Library
Cystoscopy Female Surgery PreOp® Patient Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Also called: IVP, Excretory Urography, Intravenous Urography, Intravenous Pyelogram
An intravenous pyelogram (IVP) is an x-ray exam of the urinary tract (and the prostate gland in males). It can find blockages and other problems in the urinary tract.
Intravenous Pyelogram
Also called: IVP, Excretory Urography, Intravenous Urography, Intravenous Pyelogram
An intravenous pyelogram (IVP) is an x-ray exam of the urinary tract (and the prostate gland in males). It can find blockages and other problems in the urinary tract.
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Your result is Normal.
The kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladder) have a normal shape, size, and position in the body.
Related conditions
An intravenous pyelogram (IVP) uses x-rays to take pictures of the organs of your urinary tract. These are the organs that make urine (pee) and remove it from your body. They include your:
Kidneys, two organs located below the rib cage, one on each side of your spine. They filter your blood to remove waste and extra water in urine (pee).
Bladder, a hollow organ in your pelvis (the area below your belly). It stores urine.
Ureters, thin tubes that carry urine from your kidneys to your bladder.
IVP uses contrast dye to make these organs show up well on x-ray images. In males, x-rays from an IVP can also show the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder and makes the fluid part of semen.
During an IVP, contrast dye is injected into a vein using an intravenous (IV) line. The dye travels through your bloodstream to your kidneys, which filter it out. The dye collects in the organs of your urinary tract and makes them look bright white on the x-rays. This allows your health care provider to see blockages or other problems that affect your urinary organs.
IVP isn't commonly used anymore. Instead, providers usually order CT (computerized tomography) scans to see the urinary tract. CT scans can provide more information than x-rays from an IVP. But IVP may be useful in certain situations.
Your provider can explain the pros and cons of having an IVP or a CT scan. In certain cases, MRI scans (magnetic resonance imaging) or ultrasound may also be options for looking at the urinary tract.
Other names: excretory urography, intravenous urography
An IVP may be used to help find the cause of symptoms that may involve the urinary tract or prostate. It can be used to help diagnose disorders such as:
Kidney stones
Stones in the bladder or ureters
Kidney cysts
Enlarged prostate (BPH)
Tumors in the kidneys, bladder, or ureters (cancerous and not cancerous)
Birth defects that affect the structure of the urinary tract
Scarring from a urinary tract infection (UTI)
IVP usually isn't used during pregnancy or for infants and children.
You may need an IVP if you have symptoms of a urinary tract disorder. These may include:
Pain in your side or back
Sharp pains in your abdomen (belly), side, groin or back
Blood in your urine
Cloudy or bad-smelling urine
Pain when urinating (peeing)
Needing to urinate frequently, or not being able to urinate
Nausea and vomiting
Swelling in your feet or legs
Fever and chills
You may also need an IVP if you have had many urinary tract infections or have had an injury that may have damaged your urinary organs.
An IVP may be done in your provider's office or a hospital. The test is often done by a radiology technician (a health care professional who is trained to do x-ray exams). The procedure takes about an hour and generally includes these steps:
You'll usually remove your clothing and put on a gown.
You'll lie down on your back on an x-ray table. The technician will take an x-ray to make sure the machine is set right for you.
The technician will insert an IV into a vein in your arm or hand and inject the contrast dye.
Several x-rays will be taken to see how your kidneys filter the dye. You may be asked to move into different positions.
The technician may wrap a special belt tightly around your belly. This helps keep the contrast dye in your kidneys. After the belt is removed, more x-rays will be taken to show the dye passing from your kidneys through your ureters and into your bladder.
Before the IVP is finished, you'll be asked to use the bathroom or a bedpan to urinate. Then the last x-rays will be taken to see if any urine remains in your bladder. This shows how well your bladder works to empty urine.
After the test, drinking plenty of fluids will help flush the contrast dye out of your body.
Your provider will give you instructions for how to prepare for an IVP. You will probably need to fast (not eat or drink) after midnight on the night before your test. You may also be asked to take a mild laxative the evening before the IVP. A laxative is medicine that helps you empty your bowels (poop).
There's a small chance you could have an allergic reaction to the contrast dye. Reactions can often be managed with medicine. Serious reactions are rare. But certain conditions may increase the chance of problems, such as having other allergies, congestive heart failure, or diabetes. If you have any of these conditions, tell your provider. You may be able to take medicine before the IVP to reduce the chance of reacting to the dye.
When the contrast dye is injected, you may feel itchy, warm, or queasy. Some people have a metallic taste in their mouths. These feelings are harmless and usually go away quickly.
Tell your provider if you are pregnant or think you may be pregnant. An IVP delivers a low dose of radiation. The dose is safe for most people, but it can be harmful to an unborn baby.
Your IVP images will be studied by a diagnostic radiologist. This is a doctor who specializes in examining x-rays, MRIs, and other medical images to diagnose medical conditions. The radiologist will send a report with your IVP results to your provider. The report will explain exactly what the x-rays showed.
In general:
Normal results mean that:
The organs of your urinary tract looked normal, and no blockages were seen.
Your kidneys, ureters, and bladder worked normally to filter the dye and pass it out of your body.
In males, the prostate was the right size, and no problems were seen.
Abnormal results mean that something irregular was found on your IVP images. Ask your provider to explain your report and diagnosis. Examples of abnormal results include:
One or more of urinary tract organs did not appear to be the right size or shape, or it was not in the usual place.
A tumor, stone, cyst, injury, scar, or some other abnormal area of tissue was found and may be blocking the flow of urine.
Your urinary tract did not filter the dye and/or pass it out of your body as quickly or completely as it should.
In males, the prostate was larger than normal.
Intravenous Pyelogram (IVP): MedlinePlus Medical Test [accessed on Jun 27, 2024]
Urinary Tract Imaging - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. [accessed on May 31, 2019]
Ectopic Kidney - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. [accessed on May 31, 2019]
Intravenous pyelogram: MedlinePlus Medical Encyclopedia [accessed on Oct 23, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
In an intravenous pyelogram of a medullary sponge kidney, cysts appear as clusters of light.
Drawing of a medullary sponge kidney as seen in an intravenous pyelogram. The background is black. The large part of the kidney appears to be porous, like a sponge. Two white spots on the kidney are circled. A label identifies the white spots as cysts
Image by NIDDK/NIH
Drawing of a medullary sponge kidney as seen in an intravenous pyelogram. The background is black. The large part of the kidney appears to be porous, like a sponge. Two white spots on the kidney are circled. A label identifies the white spots as cysts
In an intravenous pyelogram of a medullary sponge kidney, cysts appear as clusters of light.
Image by NIDDK Image Library
Drawing of a medullary sponge kidney as seen in an intravenous pyelogram. The background is black. The large part of the kidney appears to be porous, like a sponge
In an intravenous pyelogram of a medullary sponge kidney, cysts appear as clusters of light.
Image by NIDDK Image Library
Intravenous pyelogram (IVP)
Drawing of an IVP x-ray view of the urinary tract showing contrast medium filtering from the blood and passing through the kidneys, down the ureters, into the bladder.
Image by NIDDK Image Library
Drawing of a medullary sponge kidney (MSK)
The large part of the kidney appears to be porous, like a sponge. In MSK, cysts form in the collecting tubes and keep urine from flowing freely through the kidneys.
Image by NIDDK Image Library
MDI Radiology CT IVP 3D
Video by MDIRadiology/YouTube
How Do Kidney Stones Form? How Can We Prevent Them?
Video by VIP Urology/YouTube
In an intravenous pyelogram of a medullary sponge kidney, cysts appear as clusters of light.
NIDDK/NIH
Drawing of a medullary sponge kidney as seen in an intravenous pyelogram. The background is black. The large part of the kidney appears to be porous, like a sponge. Two white spots on the kidney are circled. A label identifies the white spots as cysts
NIDDK Image Library
Drawing of a medullary sponge kidney as seen in an intravenous pyelogram. The background is black. The large part of the kidney appears to be porous, like a sponge
NIDDK Image Library
Intravenous pyelogram (IVP)
NIDDK Image Library
Drawing of a medullary sponge kidney (MSK)
NIDDK Image Library
0:51
MDI Radiology CT IVP 3D
MDIRadiology/YouTube
7:00
How Do Kidney Stones Form? How Can We Prevent Them?
VIP Urology/YouTube
Chest X-Ray Test
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
X rays are electromagnetic waves. They use ionizing radiation to create pictures of the inside of your body. A chest x ray takes pictures of the inside of your chest. The different tissues in your chest absorb different amounts of radiation. Your ribs and spine are bony and absorb radiation well. They normally appear light on a chest x ray. Your lungs, which are filled with air, normally appear dark.
Related conditions
A chest x ray is a painless, noninvasive test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test is done to find the cause of symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), and fever.
Chest x rays help doctors diagnose conditions such as pneumonia (nu-MO-ne-ah), heart failure, lung cancer, lung tissue scarring, and sarcoidosis (sar-koy-DO-sis). Doctors also may use chest x rays to see how well treatments for certain conditions are working. Also, doctors often use chest x rays before surgery to look at the structures in the chest.
Chest x rays are the most common x-ray test used to diagnose health problems.
Doctors may recommend chest x rays for people who have symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), or fever. The test can help find the cause of these symptoms.
Chest x rays look for conditions such as pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis. The test also is used to check how well treatments for certain conditions are working.
Chest x rays also are used to evaluate people who test positive for tuberculosis (tu-ber-kyu-LO-sis) exposure on skin tests.
Sometimes, doctors recommend more chest x rays within hours, days, or months of an earlier chest x ray. This allows them to follow up on a condition.
People who are having certain types of surgery also may need chest x rays. Doctors often use the test before surgery to look at the structures inside the chest.
Depending on your doctor's request, you'll stand, sit, or lie for the chest x ray. The technician will help position you correctly. He or she may cover you with a heavy lead apron to protect certain parts of your body from the radiation.
The x-ray equipment usually consists of two parts. One part, a box-like machine, holds the x-ray film or a special plate that records the picture digitally. You'll sit or stand next to this machine. The second part is the x-ray tube, which is located about 6 feet away.
Before the pictures are taken, the technician will walk behind a wall or into the next room to turn on the x-ray machine. This helps reduce his or her exposure to the radiation.
Usually, two views of the chest are taken. The first is a view from the back. The second is a view from the side.
For a view from the back, you'll sit or stand so that your chest rests against the image plate. The x-ray tube will be behind you. For the side view, you'll turn to your side and raise your arms above your head.
If you need to lie down for the test, you'll lie on a table that contains the x-ray film or plate. The x-ray tube will be over the table.
You'll need to hold very still while the pictures are taken. The technician may ask you to hold your breath for a few seconds. These steps help prevent a blurry picture.
Although the test is painless, you may feel some discomfort from the coolness of the exam room and the x-ray plate. If you have arthritis or injuries to the chest wall, shoulders, or arms, you may feel discomfort holding a position during the test. The technician may be able to help you find a more comfortable position.
When the test is done, you'll need to wait while the technician checks the quality of the x-ray pictures. He or she needs to make sure that the pictures are good enough for the doctor to use.
You don't have to do anything special to prepare for a chest x ray. However, you may want to wear a shirt that's easy to take off. Before the test, you'll be asked to undress from the waist up and wear a gown.
You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the x-ray picture. Let the x-ray technician (a person specially trained to do x-ray tests) know if you have any body piercings on your chest.
Let your doctor know if you're pregnant or may be pregnant. In general, women should avoid all x-ray tests during pregnancy. Sometimes, though, having an x ray is important to the health of the mother and fetus. If an x ray is needed, the technician will take extra steps to protect the fetus from radiation.
Chest x rays have few risks. The amount of radiation used in a chest x ray is very small. A lead apron may be used to protect certain parts of your body from the radiation.
The test gives out a radiation dose similar to the amount of radiation you're naturally exposed to over 10 days.
Chest x rays show the structures in and around the chest. The test is used to look for and track conditions of the heart, lungs, bones, and chest cavity. For example, chest x-ray pictures may show signs of pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis.
Chest x rays do have limits. They only show conditions that change the size of tissues in the chest or how the tissues absorb radiation. Also, chest x rays create two-dimensional pictures. This means that denser structures, like bone or the heart, may hide some signs of disease. Very small areas of cancer and blood clots in the lungs usually don't show up on chest x rays.
For these reasons, your doctor may recommend other tests to confirm a diagnosis.
https://www.nhlbi.nih.gov/health-topics/chest-x-ray [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003804.htm [accessed on Aug 25, 2021]
https://www.radiologyinfo.org/en/info/chestrad [accessed on Aug 25, 2021]
https://www.emedicinehealth.com/chest_x-ray/article_em.htm [accessed on Aug 25, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Chest X-Ray Basics in 5 min
Video by Nick Smith/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
What causes Acute respiratory distress syndrome (ARDS) and who is at Risk?
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Image by Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
Tuberculosis X-ray
An anteroposterior X-ray of a patient diagnosed with advanced bilateral pulmonary tuberculosis. This AP X-ray of the chest reveals the presence of bilateral pulmonary infiltrate (white triangles), and caving forma.
Image by CDC / Der Lange
Respiratory Syncytial Virus
This highly-magnified, 1981 transmission electron microscopic (TEM) image, reveals some of the morphologic traits exhibited by a human respiratory syncytial virus (RSV). The virion is variable in shape, and size, with an average diameter between 120-300nm. RSV is the most common cause of bronchiolitis and pneumonia among infants and children, under 1-year of age.
Image by CDC/ E. L. Palmer
Q Fever Pneumonia X-ray
Combination of two x-rays (A) normal chest x-ray (B) x-ray documenting Q fever pneumonia.
Image by US Gov
Chest X Ray
A Lateral Chest X-Ray with the heart shadow outlined.
Image by US Army
Projectional radiography
Image relating focal spot size to geometric unsharpness in projectional radiography.
Image by Source images by Blausen Medical and LadyofHats (Mariana Ruiz Villarreal) Derivative by Mikael Haggstrom
Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
X-ray of Healthy Lung
This image shows an x-ray of healthy lungs.
Image by TheVisualMD
Cancer screening
Cancer Imaging: X-Rays : Chest X-rays can be used to show the presence of tumors, as for lung cancer, but they may also indicate problems associated with cancer. An X-ray may produce images suggestive of fluid accumulation, masses, or enlarged lymph nodes.
Image by TheVisualMD
Lung Cancer
Chest X-ray (Cancer): This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute
Chest X Ray
Mediastinal structures on a chest radiograph.
Image by Mikael Haggstrom, from source images by ZooFari, Stillwaterising and Gray's Anatomy creators
CT Chest Scan of Pleura effusion
CT scan of chest showing loculated pleural effusion in left side. Some thickening of pleura is also noted. From my personal collection. Permission obtained from patient.
Image by Drriad
Chest X-ray (Cancer)
This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute / Unknown Photographer
This browser does not support the video element.
CT Scans (VIDEO)
This video shows how modern science of scanning can expose the health condition of the patient. The video starts with a patient undergoing CT scanning, an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Visible are the heart, lungs, and arteries of a patient.
Video by TheVisualMD
Chest X-Ray
Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings
Arrows indicate costophrenic angles
Image by US Army
Gallstones
Gallstones as seen on plain x-ray.
Image by James Heilman, MD
Hemoptysis x-ray
Hemoptysis can be discovered with the help of radiology.
Image by Aidan Jones from Oxford, U.K.
X-ray of Lung with Pulmonary Edema
Within the lungs, the main airways (bronchi) branch off into smaller passageways, the smallest of which are called bronchioles. At the end of the bronchioles are tiny air sacs (alveoli). Pulmonary edema is a condition caused when excess fluid collects in these air sacs, making it difficult to breathe. Fluid in the lungs can be caused by pneumonia, acute respiratory distress and other conditions, but in most cases, the cause of pulmonary edema is heart problems (when a damaged heart can't pump enough blood and fluid leaks into the lungs).
Image by TheVisualMD
What To Expect During and After Implantable Cardioverter Defibrillator Surgery
A normal chest X-ray after placement of an ICD, showing the ICD generator in the upper left chest and the ICD lead in the right ventricle of the heart. Note the 2 opaque coils along the ICD lead.
Image by Gregory Marcus, MD, MAS, FACC
This browser does not support the video element.
Chest X-ray: NCI B-roll [video]
NCI B-roll of a patient receiving a Chest X-ray. This video is silent.
Video by National Cancer Institute (NCI)
X-Ray of Aneurysm within Chest frontal view
Most aneurysms are detected in the course of an exam, such as a physical exam or a chest X-ray, being performed for a different reason.
Image by TheVisualMD
Pleural Effusion: Tests
Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.
Image by CDC InvictaHOG
Coccidioidomycosis
This anteroposterior (AP) chest x-ray revealed pulmonary changes indicative of pulmonary fibrosis in a case of coccidioidomycosis, caused by fungal organisms of the genus, Coccidioides. Because these changes also resemble those seen in other lung infections including tuberculosis, the findings uncovered with a chest x-ray needs to be coupled with serologic testing, as well as possible tissue biopsy. The degree of fibrotic changes, indicative of scarring found on x-ray, can be directly correlated to the severity of the fungal infection.
Image by CDC/ Dr. Lucille K. Georg
How Is Acute respiratory distress syndrome (ARDS) Diagnosed?
Chest X-Ray: Acute respiratory distress syndrome on plain Xray
Image by James Heilman, MD
How Are Asbestos-Related Lung Diseases Diagnosed?
Early Asbestosis in a Retired Pipe Fitter : Chest X-ray in asbestosis shows plaques above diaphragm
Image by Clinical Cases
Aspergillosis
This was a photomicrograph of a lung tissue specimen, harvested from a caged, sulfur-crested cockatoo, that depicted some of the histopathologic changes that had been caused by the fungal organism, Aspergillus fumigatus, in a case of avian pulmonary aspergillosis. Here, you are able see how the periodic acid-Schiff (PAS) stain, revealed A. fumigatus ultrastructural morphology including conidial heads and mycelium.
Image by CDC/ Dr. William Kaplan
Pleural Effusion - Defined
A large left sided pleural effusion as seen on an upright chest X-ray
Image by Drriad
Pleural Effusion: Tests
A large left sided pleural effusion as seen on an upright chest X-ray
Image by James Heilman MD
Breast implants
Chest X-ray showing breast implants
Image by James Heilman
Living With Idiopathic Pulmonary Fibrosis
No cure is available for idiopathic pulmonary fibrosis (IPF) yet. Your symptoms may get worse over time. As your symptoms worsen, you may not be able to do many of the things that you did before you had IPF.
However, lifestyle changes and ongoing care can help you manage the disease.
If you're still smoking, the most important thing you can do is quit. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Ask family members and friends not to smoke in front of you or in your home, car, or workplace.
Image by Drriad
Symptoms and Spread of SARS (Severe acute respiratory syndrome)
A chest x-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS.
Image by CDC
Chilaiditi syndrome
Chest X-ray showing obvious Chilaiditi's sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm (left side of the image).
Piper's Sign: In days gone by the lateral chest x-ray (demonstrating greater opacity in the aortic arch and descending aorta than the thoracic spine) gave an indication to the degree of calcified plaque burden a patient had. This has been known as Piper's sign and can often be seen in elderly persons particularly those with concomitant osteoporosis.
Image by U4077905
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Image by Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Image by Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Fungal Parasites and Pathogens
(a) Ringworm presents as a red ring on skin; (b) Trichophyton violaceum, shown in this bright field light micrograph, causes superficial mycoses on the scalp; (c) Histoplasma capsulatum is an ascomycete that infects airways and causes symptoms similar to influenza. (credit a: modification of work by Dr. Lucille K. Georg, CDC; credit b: modification of work by Dr. Lucille K. Georg, CDC; credit c: modification of work by M. Renz, CDC; scale-bar data from Matt Russell)
Image by CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PCP), one of the most frequent and severe opportunistic infections in immunocompromised patients. Pneumocystis organisms represent a large group of species of atypical fungi with universal distribution and pulmonary tropism, and each species has a strong specificity for a given mammalian host species.
Image by CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Chest X-ray PA inverted and enhanced
Image by Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
PA view Chest X-Ray of Canadian dollar coin in esophagus of child. Released per permission of mother.
Image by Samir (talk)
Chest X Ray
Structures shown: Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings. Arrows indicate costophrenic angles
Image by US Army
Thoracic diaphragm
X-ray of chest, showing top of diaphragm.
Image by OpenStax College
Chest X Ray
Roentgenogram or Medical X-ray image. May not be to scale.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Mikael Häggström
Fungal Parasites and Pathogens
CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist.
7:02
Reading a chest X-ray
Osmosis/YouTube
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
Treatment
Vulvectomy
Vulvectomy
Vulvectomy
1
2
3
Skinning Vulvectomy
Interactive by Cancer Research UK
Vulvectomy
Vulvectomy
Vulvectomy
1
2
3
Skinning Vulvectomy
Diagram showing 3 stages of a skinning vulvectomy.
Interactive by Cancer Research UK
Vulvar Cancer Treatment Option Overview
There are different types of treatment for patients with vulvar cancer.
Different types of treatments are available for patients with vulvar cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Four types of standard treatment are used:
Surgery
Surgery is the most common treatment for vulvar intraepithelial neoplasia (VIN) and vulvar cancer.
One of the following types of surgery may be done to treat VIN:
Separate excision of a lesion: A surgical procedure to remove a lesion of concern.
Wide local excision: A surgical procedure to remove the area of skin affected by VIN and some of the normal tissue around it.
Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
Ultrasound surgical aspiration: A surgical procedure to break the tumor up into small pieces using very fine vibrations. The small pieces of tumor are washed away and removed by suction. This procedure causes less damage to nearby tissue.
Skinning vulvectomy: The top layer of vulvar skin where the VIN is found is removed. Skin grafts from other parts of the body may be needed to cover the area where the skin was removed.
The goal of surgery for vulvar cancer is to remove all the cancer without any loss of the woman's sexual function. One of the following types of surgery may be done to treat vulvar cancer:
Wide local excision: A surgical procedure to remove the cancer and some of the normal tissue around the cancer.
Radical local excision: A surgical procedure to remove the cancer and a large amount of normal tissue around it. Nearby lymph nodes in the groin may also be removed.
Vulvectomy: A surgical procedure to remove part or all of the vulva:
Modified radical vulvectomy: Surgery to remove most of the vulva. Nearby lymph nodes may also be removed.
Radical vulvectomy: Surgery to remove the entire vulva. Nearby lymph nodes are also removed.
Pelvic exenteration: A surgical procedure to remove the lower colon, rectum, and bladder. The cervix, vagina, ovaries, and nearby lymph nodes are also removed. Artificial openings (stoma) are made for urine and stool to flow from the body into a collection bag.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy and/or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward area of the body with cancer.
External radiation therapy may also be used aspalliative therapy to relievesymptoms and improve quality of life.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Topical chemotherapy for vulvar cancer may be applied to the skin in a cream or lotion. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Immunotherapy
Immunotherapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.
Imiquimod is an immune response modifier used to treat vulvar lesions and is applied to the skin in a cream.
Treatment for vulvar cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
It is important to have regular follow-up exams to check for recurrent vulvar cancer.
Source: National Cancer Institute (NCI)
Additional Materials (1)
Vulvar cancer treatment
Video by dooryim/YouTube
1:26
Vulvar cancer treatment
dooryim/YouTube
Treatment By Stage
Treating Cancer
Image by TheVisualMD
Treating Cancer
Because cancers differ from one another in many ways, and because each patient is unique, there isn`t just one approach to treatment. Cancer treatment aims to eliminate the primary tumor, prevent the recurrence or spread of the cancer, and relieve symptoms. Types of cancer treatment include surgery; radiation therapy, which targets specific cancer cells; chemotherapy, which targets cancer cells throughout the body; and biological therapy, which works with the body`s own immune system. If you have cancer, it`s important to educate yourself about the type of cancer you have and the options for its treatment so that you can make informed decisions.
Image by TheVisualMD
Vulvar Cancer Treatment Options by Stage
Treatment of vulvar intraepithelial neoplasia (VIN) may include the following:
Surgery may be one of the following:
Separate excision of lesions.
Wide local excision.
Laser surgery.
Ultrasound surgical aspiration.
Skinning vulvectomy.
Immunotherapy with topical imiquimod.
Treatment of stage I vulvar cancer and stage II vulvar cancer may include the following:
Surgery (wide local excision).
Surgery (radical local excision with removal of lymph nodes in the groin and upper thigh).
Surgery (modified radical vulvectomy or radical vulvectomy with removal of lymph nodes in the groin and upper thigh). Radiation therapy may be given.
Surgery (radical local excision and removal of sentinel lymph node) followed by radiation therapy in some cases.
Radiation therapy alone.
Treatment of stage III vulvar cancer may include the following:
Surgery (modified radical vulvectomy or radical vulvectomy with removal of lymph nodes in the groin and upper thigh) with or without radiation therapy.
Radiation therapy or chemotherapy and radiation therapy followed by surgery.
Radiation therapy with or without chemotherapy.
Treatment of stage IVA vulvar cancer may include the following:
Surgery (radical vulvectomy or pelvic exenteration).
Surgery and radiation therapy.
Radiation therapy or chemotherapy and radiation therapy followed by surgery.
Radiation therapy with or without chemotherapy.
Treatment of stage IVB vulvar cancer may include the following:
There is no standard treatment for stage IVB vulvar cancer. Chemotherapy has been studied and may be used if the patient can tolerate it.
Treatment of locally recurrent vulvar cancer may include the following:
Surgery (wide local excision) with or without radiation therapy.
Surgery (radical vulvectomy and pelvic exenteration).
Chemotherapy and radiation therapy with or without surgery.
Radiation therapy with or without chemotherapy.
Radiation therapy and surgery.
Radiation therapy as palliative treatment to relieve symptoms and improve quality of life.
Source: National Cancer Institute (NCI)
Additional Materials (1)
Topic 51: Vulvar Neoplasms
Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
5:00
Topic 51: Vulvar Neoplasms
Association of Professors of Gynecology and Obstetrics (APGO)/YouTube
Prevention
HPV Vaccine
Image by U.S. Air Force photo by Staff Sgt. Benjamin W. Stratton
HPV Vaccine
About 80 million people are infected with HPV right now in the United States. Vaccines are currently available for both males and females to help prevent the virus, which can be linked to various cancers, such as cervical cancer.
Image by U.S. Air Force photo by Staff Sgt. Benjamin W. Stratton
What Can I Do to Reduce My Risk for Vaginal and Vulvar Cancers?
The human papillomavirus (HPV) is a common virus with more than 200 different kinds or types. More than 30 of the types can be passed from one person to another through close skin-to-skin contact during sex. Almost all cervical cancers, and some vaginal, vulvar, and other cancers, are caused by HPV.
The HPV vaccine protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers.
HPV vaccination is recommended for preteens aged 11 to 12 years, but can be given starting at age 9.
HPV vaccine also is recommended for everyone through age 26 years, if they are not vaccinated already.
HPV vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV.
If vaccination is started before age 15, a two-dose schedule is recommended, with the doses given 6 to 12 months apart. For people who start the series after their 15th birthday, the vaccine is given in a series of three shots.
HPV vaccination prevents new HPV infections, but does not treat existing infections or diseases. This is why the HPV vaccine works best when given before any exposure to HPV. You should get screened for cervical cancer regularly, even if you received an HPV vaccine.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (2)
What is HPV and how can you protect yourself from it? - Emma Bryce
Video by TED-Ed/YouTube
Human Papillomavirus (HPV) Statistics | Did You Know?
Video by National Cancer Institute/YouTube
4:28
What is HPV and how can you protect yourself from it? - Emma Bryce
TED-Ed/YouTube
4:16
Human Papillomavirus (HPV) Statistics | Did You Know?
National Cancer Institute/YouTube
Human Papillomavirus (HPV) Vaccine
Human Papillomavirus (HPV) Vaccine
Also called: Gardasil®, Gardasil® 9
Human papillomavirus (HPV) vaccine can prevent infection with some types of human papillomavirus. The vaccine is given to individuals 9 through 45 years of age to help protect against diseases caused by nine high-risk types of HPV (Gardasil 9).
Human Papillomavirus (HPV) Vaccine
Also called: Gardasil®, Gardasil® 9
Human papillomavirus (HPV) vaccine can prevent infection with some types of human papillomavirus. The vaccine is given to individuals 9 through 45 years of age to help protect against diseases caused by nine high-risk types of HPV (Gardasil 9).
HPV (human papillomavirus) vaccine can prevent infection with some types of human papillomavirus.
HPV infections can cause certain types of cancers, including:
cervical, vaginal, and vulvar cancers in women
penile cancer in men
anal cancers in both men and women
cancers of tonsils, base of tongue, and back of throat (oropharyngeal cancer) in both men and women
HPV infections can also cause anogenital warts.
HPV vaccine can prevent over 90% of cancers caused by HPV.
HPV is spread through intimate skin-to-skin or sexual contact. HPV infections are so common that nearly all people will get at least one type of HPV at some time in their lives. Most HPV infections go away on their own within 2 years. But sometimes HPV infections will last longer and can cause cancers later in life.
HPV vaccine is routinely recommended for adolescents at 11 or 12 years of age to ensure they are protected before they are exposed to the virus. HPV vaccine may be given beginning at age 9 years and vaccination is recommended for everyone through 26 years of age.
HPV vaccine may be given to adults 27 through 45 years of age, based on discussions between the patient and health care provider.
Most children who get the first dose before 15 years of age need 2 doses of HPV vaccine. People who get the first dose at or after 15 years of age and younger people with certain immunocompromising conditions need 3 doses. Your health care provider can give you more information.
HPV vaccine may be given at the same time as other vaccines.
Tell your vaccination provider if the person getting the vaccine:
Has had an allergic reaction after a previous dose of HPV vaccine, or has any severe, life-threatening allergies
Is pregnant—HPV vaccine is not recommended until after pregnancy
In some cases, your health care provider may decide to postpone HPV vaccination until a future visit.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting HPV vaccine.
Your health care provider can give you more information.
Soreness, redness, or swelling where the shot is given can happen after HPV vaccination.
Fever or headache can happen after HPV vaccination.
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.
An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness), call 9-1-1 and get the person to the nearest hospital.
For other signs that concern you, call your health care provider.
Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
Vaccine Information Statement | HPV | VIS | CDC [accessed on Aug 06, 2021]
GARDASIL 9 (human papillomavirus 9-valent vaccine, recombinant) injection, suspension [accessed on Oct 14, 2019]
GARDASIL (human papillomavirus quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant) injection, suspension [accessed on Oct 14, 2019]
Human Papillomavirus 9 Valent (Types 6, 11, 16, 18, 31, 33, 45, 52, 58) Vaccine, Recombinant. AIDSinfo/U.S. Department of Health and Human Services. [accessed on Oct 14, 2019]
Gardasil 9. FDA Vaccines. [accessed on Apr 25, 2019]
Human Papillomavirus (HPV) Vaccination: What Everyone Should Know. CDC National Center for Immunization and Respiratory Diseases. [accessed on Oct 29, 2018]
Human Papillomavirus (HPV) Vaccine . MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]
FDA NEWS RELEASE: FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old [accessed on Oct 05, 2018]
These FAQs provide a summary of the most important information about Human Papillomavirus (HPV) Vaccine. If you would like more information or have any questions, talk to your healthcare provider.
Additional Materials (47)
HPV Vaccine for Preteens and Teens
HPV vaccination is recommended at ages 11-12 to protect against cancers caused by HPV infection.
Document by Centers for Disease Control and Prevention (CDC)
HPV Adolescent Vaccine Safety and Effectiveness
HPV vaccination provides safe, effective, and long-lasting protection against cancers caused by HPV.
Document by Centers for Disease Control and Prevention (CDC)
Cervical Cancer and HPV
The human papillomavirus (HPV) can cause several types of cancer. For example, almost all cases of cervical cancer are caused by HPV. HPV vaccination has the potential to reduce cervical cancer incidences around the world by two-thirds.
See also https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet.
Image by National Cancer Institute (NCI)
HPV and Cancer
The human papillomavirus (HPV) can cause several types of cancer. For example, almost all cases of cervical cancer are caused by HPV. HPV vaccination has the potential to reduce cervical cancer incidences around the world by two-thirds.
See also https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet.
Image by National Cancer Institute (NCI)
HPV and Cancer
The human papillomavirus (HPV) can cause several types of cancer. For example, almost all cases of cervical cancer are caused by HPV. HPV vaccination has the potential to reduce cervical cancer incidences around the world by two-thirds.
Image by National Cancer Institute (NCI)
HPV and Cancer
The human papillomavirus (HPV) can cause several types of cancer. For example, almost all cases of cervical cancer are caused by HPV. HPV vaccination has the potential to reduce cervical cancer incidences around the world by two-thirds.
See also https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet.
Image by National Cancer Institute (NCI)
Sensitive content
This media may include sensitive content
Improving HPV Vaccination Rates Will Help Save Lives
The HPV vaccine Gardasil 9® protects against infection with nine HPV types: the two low-risk HPV types that cause most genital warts, plus the seven high-risk HPV types that cause most HPV-related cancers.
Image by National Cancer Institute (NCI)
Preventing HPV Infection with HPV Vaccination
The HPV vaccine Gardasil 9® protects against infection with nine HPV types: the two low-risk HPV types that cause most genital warts, plus the seven high-risk HPV types that cause most HPV-related cancers.
Image by National Cancer Institute (NCI)
Cervical Cancer and the HPV Virus
HPV is the most common virus that infects the reproductive tract and Cervical cancer is by far the most common disease caused by it.
Image by Scientific Animations, Inc.
Vaccines
Thanks to a vaccine, one of the most terrible diseases in history – smallpox – no longer exists outside the laboratory. Over the years, vaccine have prevented countless cases of disease and saved millions of lives.
Image by Courtesy photo
HPV Vaccine
About 80 million people are infected with HPV right now in the United States. Vaccines are currently available for both males and females to help prevent the virus, which can be linked to various cancers, such as cervical cancer.
Image by U.S. Air Force photo by Staff Sgt. Benjamin W. Stratton
The HPV Vaccine, and Why Your Kids Should Get It: Healthcare Triage #4
Video by Healthcare Triage/YouTube
Should You Get the HPV Vaccine?
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How does the HPV vaccine work?
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HPV in the spotlight as a cause of oral cancers
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Mayo Clinic Minute: Protect your child with HPV vaccine
Video by Mayo Clinic/YouTube
HPV & Cervical Cancer | Parents
Video by Parents/YouTube
Talking with Parents Who Refuse HPV Vaccine – One Pediatrician’s View
Video by Centers for Disease Control and Prevention (CDC)/YouTube
HPV Vaccine: My Recommendation as a Doctor and a Parent
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The HPV Vaccine | Why Parents Really Choose to Refuse
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How the HPV vaccine works
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HPV vaccine: Help your kids prevent cancer
Video by MD Anderson Cancer Center/YouTube
Does the HPV Vaccine Prevent Cancer? - Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Can the HPV Vaccine Cause Infertility? – Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Why Do 11-12 Year Olds Need the HPV Vaccine? – Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
What Diseases Are Caused by HPV? – Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Do Boys Need the HPV Vaccine? – Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Is My Child Too Young to Get the HPV Vaccine? - Answers from a Pediatrician
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Can a single injection prevent cervical cancer? | NHS Behind the headlines
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Who Should Be Getting the HPV Vaccine Now?
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How the HPV vaccine works
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Should You Get The HPV Vaccine?
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FDA OKs HPV vaccine to age 45
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Are There Different HPV Vaccines?
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HPV vaccination for teenagers
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What is HPV: Your questions about HPV and the HPV vaccine answered | Cancer Research UK
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Can I Still Get HPV Vaccine if I’m Older?
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HPV Vaccination and Cervical Cancer Prevention Talk
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A boys' guide to the HPV vaccine
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HPV Vaccination and Risk of Adverse Pregnancy Outcomes
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Dr. Nita Lee on the HPV Vaccine & Cervical Cancer
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If I already had the HPV vaccine, do I need the HPV-9 vaccine?
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HPV vaccine (Gardasil®9) explained for parents and guardians – short clip 1
Video by Australian Government Department of Health/YouTube
HPV vaccination: Risk factors, sexual history shouldn't guide decisions about it
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HPV vaccine (Gardasil®9) explained for parents and guardians – short clip 3
Video by Australian Government Department of Health/YouTube
Merck’s 9-Valent HPV Vaccine, GARDASIL®9 ...
Video by BusinessWire/YouTube
HPV Vaccine for Preteens and Teens
Centers for Disease Control and Prevention (CDC)
HPV Adolescent Vaccine Safety and Effectiveness
Centers for Disease Control and Prevention (CDC)
Cervical Cancer and HPV
National Cancer Institute (NCI)
HPV and Cancer
National Cancer Institute (NCI)
HPV and Cancer
National Cancer Institute (NCI)
HPV and Cancer
National Cancer Institute (NCI)
Sensitive content
This media may include sensitive content
Improving HPV Vaccination Rates Will Help Save Lives
National Cancer Institute (NCI)
Preventing HPV Infection with HPV Vaccination
National Cancer Institute (NCI)
Cervical Cancer and the HPV Virus
Scientific Animations, Inc.
Vaccines
Courtesy photo
HPV Vaccine
U.S. Air Force photo by Staff Sgt. Benjamin W. Stratton
6:52
The HPV Vaccine, and Why Your Kids Should Get It: Healthcare Triage #4
Healthcare Triage/YouTube
8:47
Should You Get the HPV Vaccine?
DocMikeEvans/YouTube
1:31
How does the HPV vaccine work?
Cancer Council Victoria/YouTube
0:33
HPV in the spotlight as a cause of oral cancers
News Direct/YouTube
1:00
Mayo Clinic Minute: Protect your child with HPV vaccine
Mayo Clinic/YouTube
7:48
HPV & Cervical Cancer | Parents
Parents/YouTube
1:31
Talking with Parents Who Refuse HPV Vaccine – One Pediatrician’s View
Centers for Disease Control and Prevention (CDC)/YouTube
0:31
HPV Vaccine: My Recommendation as a Doctor and a Parent
Centers for Disease Control and Prevention (CDC)/YouTube
4:45
The HPV Vaccine | Why Parents Really Choose to Refuse
Johns Hopkins Medicine/YouTube
2:48
How the HPV vaccine works
WHO Regional Office for Europe/YouTube
1:28
HPV vaccine: Help your kids prevent cancer
MD Anderson Cancer Center/YouTube
0:47
Does the HPV Vaccine Prevent Cancer? - Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
0:52
Can the HPV Vaccine Cause Infertility? – Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
0:53
Why Do 11-12 Year Olds Need the HPV Vaccine? – Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
0:54
What Diseases Are Caused by HPV? – Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
0:46
Do Boys Need the HPV Vaccine? – Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
0:45
Is My Child Too Young to Get the HPV Vaccine? - Answers from a Pediatrician
Centers for Disease Control and Prevention (CDC)/YouTube
1:27
Can a single injection prevent cervical cancer? | NHS Behind the headlines
NHS/YouTube
1:51
Who Should Be Getting the HPV Vaccine Now?
Medscape/YouTube
3:05
How the HPV vaccine works
Australian Government Department of Health/YouTube
3:48
Should You Get The HPV Vaccine?
Seeker/YouTube
2:51
FDA OKs HPV vaccine to age 45
UW Medicine/YouTube
2:26
Are There Different HPV Vaccines?
The Children's Hospital of Philadelphia/YouTube
3:20
HPV vaccination for teenagers
Cancer Council Victoria/YouTube
1:45
What is HPV: Your questions about HPV and the HPV vaccine answered | Cancer Research UK
Cancer Research UK/YouTube
3:09
Can I Still Get HPV Vaccine if I’m Older?
The Children's Hospital of Philadelphia/YouTube
1:14:38
HPV Vaccination and Cervical Cancer Prevention Talk
Singapore Cancer Society/YouTube
1:59
The Human Papillomavirus (HPV) Vaccination and Cervical Cancer
Singapore Cancer Society/YouTube
1:53
A boys' guide to the HPV vaccine
Cancer Council Victoria/YouTube
1:57
HPV Vaccination and Risk of Adverse Pregnancy Outcomes
NEJMvideo/YouTube
3:58
Dr. Nita Lee on the HPV Vaccine & Cervical Cancer
UChicago Medicine/YouTube
1:51
If I already had the HPV vaccine, do I need the HPV-9 vaccine?
The Children's Hospital of Philadelphia/YouTube
1:19
HPV vaccine (Gardasil®9) explained for parents and guardians – short clip 1
Australian Government Department of Health/YouTube
2:52
HPV vaccination: Risk factors, sexual history shouldn't guide decisions about it
Michigan Medicine/YouTube
0:55
HPV vaccine (Gardasil®9) explained for parents and guardians – short clip 3
Australian Government Department of Health/YouTube