Pap Smear

What Is a Pap Smear?

Cervical cancer screening, commonly referred to as a pap smear, is a test performed on a routine basis to monitor the state of cervical cells. Cervical cancer is often the result of cellular mutation caused by the human papillomavirus, a common infectious condition that most women, and men, contract at some point. Many HPV infections cause only low-grade changes in the body. Some, however, can lead to cancer.

Why Do I Need a Pap Smear?

Based on your history and age, your doctor may recommend you have a Pap Smear for different reasons:

• To look for signs of Pre-cancerous cells or Cervical Cancer
• HIV infection
• A Weakened immune system due to organ transplant or chemotherapy
• Exposure to DES (Diethylstilbestrol) before birth

How Often Should I Have a Pap Test?

The frequency of screening is between the patient and the provider, a guideline is to screen no less frequently (with a history of normal paps) every three years. Doctors recommend you begin Pap testing at age 21. If you are age 30 or over, You can have a Pap test every 5 years.

Does a Pap Test Hurt?

The Pap Smear Test does not hurt. You may feel a little pinch or a bit of pressure, which could be a little uncomfortable for some.

Pap Smear Test Results

Results usually take a couple of days to get back and they will be either negative or positive. A negative result is a good thing, it means your doctor did not find any strange cells on your cervix.

If results come back positive, this is what is consider an Abnormal Pap Smear. This does not mean you have cancer, However, it does mean your doctor will want to do further testing or examination to be certain is not an inflammation or minor cell changes.

Why Would a Pap Smear Be Abnormal?

If your Pap smear or HPV results indicate an abnormality, we will explain what this means in an understandable and supportive way. It is important to know that a “positive” Pap test does not mean you have cervical cancer. It only means that the cells that have been collected fall into one of the outlined categories of abnormality.

What Are the Categories of Abnormal Pap Results?

Abnormal Pap results are categorized as:

• ASC-US., atypical squamous cells of undetermined significance. This result is almost always associated with HPV infection and is one of the most common “positive” results to occur.
• LSIL, low-grade squamous intraepithelial lesion. This is also associated with HPV infection and will often clear up spontaneously.
• HSIL, high-grade squamous intraepithelial lesion is a more concerning abnormality that indicates cellular morphology that may suggest precancer or cancer.
• Atypical squamous cells indicate a higher risk for HSIL.
• AGC, atypical glandular cells also raise concern for the existence of precancerous or cancerous cells within the inner cervical canal.

What Exactly Does an Abnormal Pap Tell Me?

This is an important question. Pap smear results only tell us that an abnormality exists in the cells of the cervix. Results do not necessarily measure the severity of these changes. Therefore, an abnormal Pap smear, depending on the category of results, may warrant further diagnostic testing. Abnormal results could mean that your cervix is inflamed, or that infection is present. Your healthcare provider will discuss your results, and what they could mean, in detail with you.

Follow-Up Testing After Abnormal Pap Smear

There are several tests that may be recommended after an abnormal Pap smear. Which tests, if any, will be explained to you by your healthcare provider.

• Repeat Pap testing is a common follow-up for an initial abnormal result and other factors, including age. Repeat testing may be scheduled in as little as one year, or as much as 3 years.
• HPV testing may be performed on the initial sample of cells used in your Pap smear. This test focuses on finding evidence of certain types of human papillomavirus.
• This diagnostic procedure is conducted to obtain a small tissue sample for examination. This sample will indicate the presence of CIN, or Cervical intraepithelial lesion, and its grade, or degree of cellular change.
• Endometrial sampling obtains a sample of tissue from the lining of the uterus. This test is general indicated only when atypical glandular cells are found in the initial Pap smear.

What Type of Treatment Is Performed for Abnormal Cervical Cells?

Because abnormal cervical cells could lead to serious health risks, treatment is planned in instances where precancer or cancer is suspected. Cervical cells may be removed via excision or ablation.

Excision may involve:

• Removal using a mildly electrically-charged wire loop referred to as LEEP, or loop electrosurgical excision procedure.
• Removal of a cone-shaped piece of cervical tissue where abnormal cells have been identified. This is referred to as conization.

Ablation may involve:

• Laser therapy, which destroys tissue containing abnormal cells.
• Cryotherapy, which freezes the precancerous or cancerous tissue. Cells then slough off.

Is There Anything I Can Do to Avoid Abnormal Pap Results?

There is no evidence that healthy lifestyle habits conclusively reduce the risk of cervical cancer. This condition is largely caused by the HPV virus, which most sexually active people get. What you can do is reduce the risk of false positive by scheduling your Pap several days before or after your period, as menstrual blood may be picked up as an abnormal result. Also, avoid sexual intercourse, feminine hygiene products, and tampon use for 2 days before your Pap.