Current use of the Papanicolaou smear

The Papanicolaou smear is an extremely useful screening technique for early detection of cervical neoplasia. The recent clarification of cervical intraepithelial neoplasia (CIN) as a continuum of dysplasia has ramifications for management. The modern reporting scheme includes a narrative portion that gives the clinician information beyond the original Class I-V. This is especially helpful in interpretation of the atypical smear. The recent findings of invasive disease following an atypical smear and the malignant potential of condylomatous changes have resulted in early use of colposcopy in these clinical situations. This article discusses Papanicolaou smear technique, reporting classifications, and management of the patient who has an abnormal smear.