Explaining Your Abnormal Pap Test
What is an abnormal Pap Test?
The Pap Test is a screening test used to detect cervical cancer or cellular changes which, if ignored, might develop into cervical cancer. The cells in the specimen collected during your pelvic exam are examined and classified as normal (negative) or abnormal. The abnormal cells are further described according to how they appear under a microscope.
What causes an abnormal Pap?
Most abnormal Paps are caused by Human Papilloma Virus, or HPV, a family of common viruses. Most sexually active people have been exposed to HPV at some point. Most of the time, HPV infections are subclinical, that is, they cause no signs or symptoms at all. A small percentage of infected people will develop signs of HPV infection, which can range from genital warts to cervical cancer. There are many different strains of HPV, and of these, a handful are designated “high risk” strains, because they are the ones that cause cervical cancer.
There is an HPV test that detects the high risk strains, and it can be used with the Pap test to guide follow-up decisions.
Explanation of Pap abnormalities
ASCUS - atypical squamous cells of undetermined significance. These are cells which appear abnormal but the cause is unclear. If you have this finding, an HPV test is automatically done for women age 21 and over. If high risk HPV strains are detected, further evaluation with colposcopy is recommended. If the HPV test is negative, you can resume routine Pap screening.
ASC-H - atypical squamous cells - cannot exclude high grade lesion. These are cells which appear abnormal but the cause is unclear. You will be advised to have a colposcopy.
LSIL -Low grade squamous epithelial lesion signifies a mild cellular change which is not thought to be precancerous. It is usually caused by HPV infection. Women under 21 can simply get a repeat Pap in one year. Women 21 or over are advised to have a colposcopy to confirm the findings.
HSIL - High grade squamous epithelial lesion describes cellular changes that are believed to be precancerous. Women of all ages should have colposcopy to confirm the diagnosis.
AGUS – atypical glandular cells of undetermined significance. This abnormality of the glandular cells should be further evaluated.
What is a colposcopy?
Colposcopy is an examination of the cervix that enables a definitive diagnosis of your abnormal Pap. A specially trained physician looks at your cervix with the aid of a microscope (a colposcope). Under magnification, abnormal areas can be identified and sampled by taking small biopsies.
The biopsy specimens are evaluated by a pathologist. Your doctor can then make a recommendation for follow-up based on a precise diagnosis.
Most of the time, cervical biopsies confirm a low-grade (minor) change that requires no treatment. If a precancerous change is found, your doctor can review the treatment options.
How can I prevent cervical cancer?
- Get immunized with Gardasil, which protects against the two most common high risk strains of HPV that cause cervical cancer as well as the two most common HPV strains that cause genital warts.
- Use condoms. Although condoms are not completely effective at preventing HPV infections, they greatly reduce the risk of transmission if used consistently.
- Limiting the number of lifetime sexual partners decreases your risk of being exposed to HPV.
- Avoid smoking. Smoking specifically interferes with cervical immune function.
- Keep up with recommended Pap tests. Precancerous changes detected by Pap tests can be treated to prevent cervical cancer from developing.