So You Received An Abnormal Pap Smear

First, let’s help you get the best understanding of your diagnosis as possible. Then we’ll cover management options.

Pap Tests Can Put Time on Your Side

The Pap test takes little time and may save your life. This simple screening test checks for cell changes in the cervix, the opening of the uterus. If your Pap results were abnormal, you may be worried. The good news is that cervical problems when caught early can almost always be treated. And the sooner a problem is caught, the better. Read on to learn about abnormal Pap results and what to do next.

When Your Results Are Abnormal

Don’t Panic. An abnormal Pap test results can mean many things. It may be due to changes (inflammation) caused by normal cell repair or infection. Or you may have a problem that could become cervical cancer. If so, know that early stages of this disease tend to progress slowly. That’s why it’s so important to have Pap tests as often as directed. pap tests can show cell changes in the cervix early, when treatment is most effective.

Ask to Talk to Your Panhandle OBGYN Provider

Be sure to discuss your results with your healthcare provider. Find out about any follow-up tests you’ll need. You may be asked to come back for a second Pap test in a few months. Or, you may be scheduled for an exam so your healthcare provider can get a closer look at your cervix. In either case, be sure to keep your follow-up visits. They are one of your best safeguards against future problems.

Understanding Your Risk

Some lifestyle choices can increase your risk of abnormal cell changes. Did you start having sex at a young age? Have you ad many sexual partners? Have you had sex without using a latex condom? Do you smoke? If you answered yes to any of these questions, you are more at risk. One of the most common reasons for an abnormal Pap result is infection with the human papillomavirus (HPV). If your Pap results suggest HPV, further testing may be needed.

Learning More About HPV

HPV is a family of viruses that spread through skin contact. Some types cause genital warts (condyloma). And a few HPV types can cause cell changes (dysplasia) in the cervix that may lead to cancer. But HPV does not always cause symptoms. In fact, many people who are infected don’t know it. However, if you know that you have HPV, you can take steps to control the spread of virus.

Limit your number of sexual partners.

Talk about your sexual histories before having sex with a new partner.

Use latex condoms each time you have sex. This helps avoid passing HPV.

Talk to your partner about your Pap results, especially if they suggest an HPV infection.

What is the Pap Test?

For two days before your Pap test, don’t douche, use vaginal creams, or have sex. During the test:

An instrument called a speculum holds the vagina open. This lets your healthcare provider see the cervix.

A small brush or swab is used to take cells from several areas of the cervix. The cells are put into a liquid or on a slide. They are then sent to a lab where they are studied for changes. Your healthcare provider will contact you with the results.

Cervical cells are put into a fluid or on a slide and sent to a lab for evaluation.

Cervical Cells slide

Understanding Your Results

The lab studies your cell samples and reports any abnormal cell changes. Your healthcare provider can discuss these changes with you. In some cases, an abnormal Pap test is due to an infection. More serious cell changes range from dysplasia to cancer.

Normal Results

Cervical cells, even normal ones, are always changing. As they mature, normal squamous cells move from deeper layers within the cervix. Over time, these cells flatten and cover the surface of the cervix. Within the cervical canal, the cells are different. These glandular cells are taller and not as flat as the cells on the surface of the cervix. When a Pap test sample shows healthy cells of both types, the results are negative. Keep having Pap tests as often as directed.

Abnormal Results

A positive Pap test result means some cells in the sample showed abnormal changes. These results are grouped by the type of cell changes and the location, or extent, of the changes. Talk to your healthcare provider about your Pap test. Depending on the results, you may need further testing. (NOTE: There are graphics not included in this post that are provided in a handout sheet which you can get for free at our offices. Call us today for more information)

Inflammation: Noncancerous changes are present. They may be due to normal cell repair. Or, they may be caused by an infection, such as HPV or yeast. Further testing may be needed. (Also called reactive cellular changes)

Atypical squamous cells: Test results are unclear. Cells on the surface of the cervix show changes, but their significance is not yet known. Testing for HPV and other STDs may be needed. Treatment may be required. (Reported as ASC-US or ASC-H)

Atypical glandular cells: Cells lining the cervical canal show abnormal changes. Further testing is likely. You may also have treatment to destroy or remove problem cells. (Reported as AGC.)

Mild dysplasia: Cells show distinct changes. More testing or HPV typing (see below) may be done. You may also have treatment to destroy or remove problem cells. (Reported as low-grade SIL, CIN 1.)

Moderate to severe dysplasia: Cells show precancerous changes. Or, noninvasive cancer (carcinoma in situ) may be present. Treatment to destroy or remove problem cells is likely. (Reported as high-grade SIL or CIN 2 or CIN 3.)

Cancer: Cancer has spread deep into or beyond the cervix. Tests to assess the cancer’s extent are likely. The type of treatment will depend on the test results and other factors, such as age and health history.

Your Diagnosis and Treatment

Depending on your Pap test results, other tests or procedures may also be done to help diagnose or treat your problem. If your healthcare provider needs a closer look at cells, he or she may view the cervix through a special instrument (colposcope). Tissue samples may be taken at this time. Certain types of treatment can also be performed during colposcopy.

HPV Typing

If signs of HPV showed up in your cell sample, HPV typing may be done. This checks your cell sample to find out which type of HPV you have. There are many types of HPV, and they affect the body in different ways. Some types are more likely than others to cause cervical cancer. Knowing the type of HPV helps your healthcare provider plan for follow-up and treatment.

Colposcopy

Your healthcare provider can use a colposcope to look at changes on the surface of the cervix. This takes only a few minutes. If a problem is suspected, you may need procedures to further assess or treat it. Or, you may simply need follow-up visits to check on the health of your cervix. As with Pap tests, colposcopy may be repeated to check your cervix over time. Your healthcare provider can see the cervix more closely through a colposcopy.

Colposcopy and Other Procedures

Colposcopy may reveal that you need more tests or treatment. Some procedures can be done at the time of the colposcopy. Expect them to take no more than 15 – 30 minutes. You may have some cramping during a procedure. Some women have light spotting for a few days afterward. This is normal. A non-aspirin pain reliever, such as ibuprofen, can help reduce any discomfort.

Biopsy

Using the colposcope as a guide, your healthcare provider may perform a biopsy. During this procedure, a small sample of tissue is removed from the cervix. The sample is then studied under a microscope for signs of cancer or other problems. More than one area of the cervix may be biopsied.

Endocervical Curettage

The cervical canal cannot be seen with colposcopy. So, to detect problems in the cervical canal, you may need endocervical curettage. During this procedure, cells are scraped from the canal wall. These cells can then be studied under a microscope. This procedure os often done along with a biopsy.

Destroying Abnormal Cells

Your healthcare provider may destroy abnormal cells on the cervix. this may be done by freezing the cells (cryotherapy). Or, the cells may be destroyed with a beam of high-energy light (laser surgery).

Removing Abnormal Cells

To remove abnormal cells, your doctor may use a cutting laser, electric loop (loop electrosurgical excision procedure or LEEP), or another surgical instrument to remove a small section of the cervix. In some cases, a cone biopsy is done. This procedure removes a cone-shaped piece of tissue extending from the center of the cervix into the canal.

Follow Up for Life

To stay healthy, follow up with your healthcare provider. If you’ve had an abnormal Pap, your healthcare provider may want you to be checked more often. In most cases, the Pap test will be repeated in a few months. This helps make sure your cervix is back to normal. Give yourself the best chance for cervical health. Have Pap tests as often as recommended for the rest of your life.

DISCLAIMER: This post is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.