What
causes abnormal Pap smears? Abnormal
Pap smear results are often explained by an infection or an inflammation. Yeast
infections, herpes, trichomonas, recent sexual activity, or use of vaginal preparations,
are often things which cause an abnormal Pap smear result. Many
times the culprit is HPV or human papilloma virus, sometimes referred to as genital
warts. HPV is a common infection in women and has been detected in women in their
seventies; up to 60% of sexually active women may carry this virus on their cervix,
genital area, or skin and are completely unaware of it. Answers
about your abnormal Pap smear Very
few experiences can be as frightening as receiving a call that your pap smear
came back abnormal. Although cervical cancer is the first thing that may comes
to mind, most of the time an abnormal pap smear indicates a minor problem with
the cervix that may or may not need treatment. The
Test Results Most
labs in the United States use the "Bethesda System" to describe Pap test results.
This standard system helps doctors plan treatment if needed. Under this system,
your results will be placed in one of several groups: - Normal
(negative):
Only normal cells are seen. There are no signs of cancer or precancer.
Cells are called precancerous when there are changes in them that may, but do
not always, become cancer.
- Atypical
squamous cells (ASC):
Some cells were seen that cannot be called normal,
but do not meet the requirements to call them precancer. The abnormal cells may
be caused by an infection, irritation, intercourse, or may be precancerous.
- SIL (squamous
intraepithelial lesion):
Changes were seen in the cells that may show signs
of precancer. SIL can be low grade or high grade. - Low-grade
SIL (LSIL):
Early, mild changes were seen in the size or shape of cells.
- High-grade
SIL (HSIL):
Moderate or severe cell changes are seen. HSIL changes on a Pap
test suggest an increased risk of "precancer" being present than with LSIL changes.
- Atypical
glandular cells:
Cell changes were seen that represent an abnormality that
needs to be evaluated more closely. The type of evaluation depends on your age
and other factors.
Follow-Up
Cells
taken from the surface of the cervix sometimes look abnormal. Usually abnormal
cells are not cancer. Abnormal cells may go through many stages of change before
cervical cancer appears. This often happens over a number of years.
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Risk
Factors Previously
treated for cancer Human
immunodeficiency virus (HIV) infection Weakened
immune system (for instance, because you have had a kidney transplant) Exposure
to the drug diethylstilbestrol (DES) before birth
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If
the lab finds abnormal cells, more tests may be suggested. This may be as simple
as a repeat Pap test. Your
doctor also may want to test for human papillomavirus (HPV). HPV is a group of
related viruses, a few of which are linked to cervical changes. Recent studies
have shown some types of HPV to cause cancer of the cervix. Most women with HPV
do not develop precancer of the cervix. Genital HPV can be passed from person
to person through sexual contact. In
some cases, the HPV test can be done to help clarify the Pap test results. A negative
HPV test result often means that the cell changes that were seen are not related
to precancer. Sometimes the sample taken for your Pap test also can be used for
an HPV test. In this case, you would not need to see the doctor again for your
HPV test. Sometimes
an exam called a colposcopy may be advised. This exam uses a device like a microscope
to look at the cervix. It allows your doctor see changes that may mean abnormal
cells are present. Colposcopy is a quick procedure done in the office setting.
If an area of
abnormal cells is seen, a biopsy may be done. For a biopsy, the doctor removes
a small sample of tissue and sends it to a lab to be studied. Colposcopy and biopsy
will help in decisionmaking as to whether treatment is needed. Treatment
depends on the test results. A woman often can be treated in her doctor's office.
Talk with your doctor if you have questions about your Pap test or other test
results. Back
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for more information on Gynecology/Urogynecology.
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