Abnormal Pap Smear Tests: What Do They Mean?
Posted: Tuesday, July 31, 2007
by Natasha Smith
Each year, millions of women take a Pap smear test during their yearly gynaecological checkups. All women who have ever had sexual intercourse and women who are currently taking birth control pills are advised to take the test. Women who become pregnant, who are experiencing pelvic pain, who have unexplained abnormal discharge, or who notice anything unusual on their genitals (such as warts or pimples) should also take the test.
If done regularly, Pap smear tests can be a preventative measure for the development and progression of cancer or cell abnormalities that my lead to cancer. Any abnormal changes can be spotted early, and if hazardous, they can be dealt with quickly using simple procedures. Also, as with most types of cancer, cervical cancer is more likely to be treated successfully if it is detected early.
A Normal Pap Smear
A normal Pap smear result means that all cells in the sample were determined to be a healthy size and shape.
An Abnormal Pap Smear
About 6% of Pap smear results are abnormal and require medical follow-up. However, it is important to remember that an abnormal result does not always mean cancer, and some conditions are more likely to lead to cancer than others.
Sometimes, an abnormal result can be produced by a contamination of the test, such as interference by menstrual blood. This is why it is important to schedule a pelvic exam 10-20 days after the first day of your last period, and why you should not have intercourse, douche, or use spermicide 24 hours before your exam. These things may interfere with the results of the Pap smear.
If you do receive abnormal results after a Pap smear, the abnormalities may be categorised in several ways:
- Dysplasia: This term is used to describe abnormal cells. Although this is not cancer, it may develop into very early cancer of the cervix. The cells look abnormal under the microscope, but they do not invade the healthy tissue nearby. Dysplasia can be classified as mild, moderate, severe, or carcinoma in situ. Carcinoma in situ means that cancer is only present in the layer of cells on the surface of the cervix and it has not spread to nearby tissues.
- Squamous Intraepithelial Lesion (SIL): This means that abnormal cells are only present in the layer of cells on the surface of your cervix. SIL can be described as low-grade (early changes in the size, shape, and number of cells) or high-grade (precancerous cells that look very different from normal cells).
- Cervical Intraepithelial Neoplasia (CIN): This term also refers to abnormal cell growth on the surface of the cervix. The term CIN and the numbers 1 to 3 describe how far abnormal cells are into the thickness of the lining of the cervix.
- Atypical Squamous Cells: This means findings are unclear, and there is not a definite abnormality.
The Next Steps
If you get abnormal Pap smear results, the first thing your doctor will want to do is repeat the test. If the results were abnormal because of contamination, this may clear up any concerns. Also, cervical cell changes sometimes go away without treatment.
If you are a woman near or past menopause, your doctor may prescribe estrogen cream to apply for a few weeks. Sometimes abnormal changes are due to hormone levels, and this may clarify the cause of cell changes.
The doctor may also examine the vagina and the cervix further by using an instrument much like a microscope (called a coloscope) in a procedure called a coloscopy. During this procedure, the doctor coats the cervix with a dilute vinegar solution that makes any abnormal tissue turn white.
If abnormal tissue if found during the coloscopy, the doctor may perform a biopsy. This is the removal of cells from the abnormal area for further examination under a microscope. Under further examination, abnormal cells can be identified as problematic or not.
If the abnormal cells have a high chance of becoming cancer, further treatment is needed to remove these cells. This can often be done in simple, in-and-out procedures that although uncomfortable, can prevent the development and spread of cancer. Examples of such procedures include:
- Loop Electrosurgical Excision Procedure (LEEP): An electrical current is passed through a thin wire loop to act as a knife to remove the cells.
- Cryotherapy: Abnormal tissue is destroyed through freezing.
- Laser therapy: A narrow beam of intense light is used to destroy or remove abnormal tissue.
For more information on women's health issues, including information on general, mental, and reproductive health, as well as STDs, birth control, infertility, pregnancy, beauty, and fitness, please visit these helpful sites:
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Top-level comments on this article: (3 total)Thanks so much for the info. I can't believe that this site didn't have anything on Pap smears before your article - they're so important!!
no comment but well written!
I always wondered what would happen if a Pap Smear came out detecting something...
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