Pap smear is a simple and effective screening test which helps detect cervical cancer in its initial stage. The test is named after its inventor Dr. Georgios Papanikolaou. Most women are afraid of this test as they do not know what it is. But it is because of the widespread use of this test, that the percentage of cervical cancer in women has significantly lowered in all parts of the world.
Pap Smear Guidelines
According to the Pap smear guidelines, every women in the age group 21 to 29 should undergo a Pap smear test, every two years. After becoming sexually active, all women should undergo a Pap test within 3 years. If required, the test is also performed during pregnancy. Abnormal test results do not necessarily indicate cancer. Benign cell growth can also be detected with the help of this test. Malignant growth of cells indicate cervical cancer. During the test, a few cells are taken from the cervix and are tested for abnormalities. If doctors have any doubts, they order some more tests such as colposcopy and biopsy. Sometimes doctors might repeat the test for correct diagnosis. Various situations are responsible for the growth of abnormal cells.
Reasons for Atypical Pap Smear
- Sexually transmitted diseases like herpes or gonorrhea
- Human Papillomavirus (HPV) infection
- Sex with more than one partner
- Genetic factors, family history of cervical cancer
- Unprotected sex
- Excessive smoking or excessive consumption of tobacco
Pap test results can be simply classified into low-grade abnormalities and high-grade abnormalities. Presence of HPV virus indicates abnormality but it does not indicate cancer. HPV is sexually transmitted and HPV infection can cause changes in squamous cells. There can be mild abnormality, so doctors may suggest more tests to confirm the reason behind abnormal squamous cells. Proper treatment is essential to get rid of this infection, otherwise it may lead to cancer. High grade abnormality in Pap smear results also suggest HPV infection but in this case, the infection is found to be of severe kind. But this also does not confirm cancer. More tests are advised and after a thorough examination of all the test results, doctors can arrive at the final conclusion. The following table will help you know how abnormal cells found during a Pap test are reported.
Interpretation of Pap Smear Results
|Test Result||Meaning||Description||Comment||Tests and Treatment|
|ASC-US||Atypical squamous cells of undetermined significance||Squamous cells not completely normal. The changes can be due to the presence of human papillomavirus (HPV) infection||Mild abnormalities||HPV testing, a repeat Pap test, colposcopy and biopsy, use of estrogen cream might be recommended|
|ASC-H||Atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion||Squamous cells not completely normal||Suggest increased risk of being precancerous||Colposcopy and biopsy|
|AGC||Atypical glandular cells||Glandular cells not completely normal||Mucus producing glandular cells are present in the endocervical canal (opening in the center of the cervix) or in the lining of the uterus.||Colposcopy and biopsy and/or endocervical curettage|
|AIS||Endocervical adenocarcinoma in situ||Precancerous cells found in glandular tissue||At higher risk of having cervical cancer||Colposcopy and biopsy and/or endocervical curettage|
|LSIL||Low-grade squamous intraepithelial lesion||Early changes in the size and shape of cells. Lesion means an abnormal area of the tissue. Intraepithelial cells are the cells that constitute the surface of the cervix.||Mild abnormalities caused by HPV infection. Also referred to as mild dysplasia or cervical intraepithelial neoplasia -1 (CIN - 1)||Colposcopy and biopsy|
|HSIL||High grade squamous intraepithelial lesion||Significant changes in the size and shape of the abnormal (precancerous) cells, abnormal cells look totally different from normal cells||More serious abnormalities and increased chances of developing invasive cancer. This condition is also reported as moderate dysplasia or severe dysplasia or CIN - 2 or CIN - 3 or carcinoma in situ (CIS)||Colposcopy and biopsy and/or endocervical curettage. Further treatment with LEEP, cryotherapy, laser therapy, conization, or hysterectomy|
It should be borne in mind that Pap smear is a test used for diagnosis, so the test results should not be considered as final diagnosis. Abnormal Pap test results indicate that you should undergo some more tests. 10% Pap tests are abnormal and most of them are not serious. Proper and prompt treatment for HPV virus infection eliminates the possibility of developing cervical cancer.