Cervical cancer screening with Pap smear is an effective regime for detecting early cellular changes in the cervix and preventing the development of cancer. It has greatly reduced the prevalence of cervical cancer where widespread screening of the population is practiced. The categories for Pap smear results have changed over time and the relevant professional societies have developed guidelines to help physicians manage their patients. The guidelines provide for levels of intervention consistent with the statistical risks of cancer associated with different categories of Pap smear results. While preventing cancer is the top priority of the guidelines, avoiding overtreatment of patients at low-to-minimal risk of future cancer is an important goal.
The HPV type 16 virus is found in cervical cancers and is considered a risk factor for the development of cervical cancer. However, its presence in a screening Pap smear is not an indication for treatment. No medications or procedures eliminate HPV from cervical tissue. If cervical biopsy diagnoses precancerous tissue or dysplasia, LEEP removes the affected area of tissue from the cervix, but only high-grade dysplasia presents the potential for cancer that requires such treatment. Therefore, the performance of a LEEP with only low-grade or mild changes on biopsy is unindicated; only a follow-up Pap smear in one year is required.