Dawaa Reference

chronic

Abnormal Cervical Smear (Pap Test)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GS50 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Preventing Cervical Cancer: Best Practices in Pap and HPV Testing - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK557551/

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Abnormal Cervical Smear (Pap Test) - disease-level clinical article (abnormal-cervical-smear-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Tests (9)

  • ASCUS aged 21 to 24: repeat the smear in 1 year if HPV is positive or unknown; reflex HPV on the same sample is also acceptable
  • ASCUS with a negative HPV test: back to routine screening in 3 years, at any age
  • ASCUS aged 25 to 29 with positive HPV: colposcopy now, rather than waiting a year for a repeat smear
  • ASCUS aged 30 to 65 with HPV positive or unknown: repeat the smear within 4 months
  • LSIL: repeat the smear in 1 year
  • ASC-H or HSIL: colposcopy
  • AGC: endocervical sampling and endometrial biopsy to source the cells, plus HPV status and a targeted family history
  • AIS: immediate diagnostic excision with endocervical and endometrial biopsy, to confirm it and to measure invasion
  • Squamous cell carcinoma on cytology: immediate excision and further workup

If not this — what else fits (3)

  • Screening is recommended from age 21 to 65; below 21 HPV is usually cleared spontaneously
  • About 3.8% of Pap tests are abnormal
  • The test is not 100% sensitive, which is why screening is repeated rather than done once

SourceStatPearls "Abnormal Papanicolaou Smear" (NBK560850) - the result-management chapter; it gives what each Bethesda category triggers (ACOG strategies), not a symptom pathway

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

An abnormal smear result (dysplasia or CIN) needs colposcopy and possible biopsy or excisional treatment, which is outside GP prescribing; the GP's role is explaining the result and arranging referral. - Refer, with advice

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

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

Why

An abnormal smear result (dysplasia or CIN) needs colposcopy and possible biopsy or excisional treatment, which is outside GP prescribing; the GP's role is explaining the result and arranging referral.

Cautions
  • RED FLAG - Visible cervical lesion or mass on speculum examination (suspected invasive cervical cancer): assess urgently and refer.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Unexplained bleeding or postmenopausal bleeding warrants evaluation for possible cervical cancer or neoplasm.
  • RED FLAG - High-grade dysplasia (CIN 2 or worse), or postmenopausal or contact bleeding alongside the abnormal result: assess urgently and refer.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.