Abnormal Pap Smear Causes

The Pap smear test or the Pap test examines the cells collected from the cervix. Cervix is the lower narrow end of the uterus. Non cancerous conditions such as infection and inflammation, abnormal cells that may lead to cancer or the cancer of the cervix can be detected by the examination of the cells collected. A doctor can find out from a pelvic exam whether there are any abnormalities in the uterus, ovaries, fallopian tubes, vagina, bladder or rectum. Such abnormalities can lead to cervical cancer.

Pap smear is named after its developer George Papanicolaou. During last 50 years, there has been a noteworthy drop of fatalities arising out of cervical cancer. This was possible because of the popularity of Pap smear test. In the U.S., about 55 million Pap tests are performed every year and about 6% (3.5 million) are found abnormal. The patients, diagnosed with abnormalities require medical follow-up so that the doctor will know the causes of abnormalities and can design the treatment, accordingly.

Causes of Abnormal Pap Smear Results

• Sexually transmitted diseases like herpes or gonorrhea
• Human Papillomavirus (HPV) infection
• Sex with more than one partner
• Family history of cervical cancer
• Sex without using any protection
• Excessive smoking or use of tobacco

The patient has to undergo a few more tests. Test results help determine the exact reason behind the change observed in the collected cells. Colposcopy or biopsy may be recommended to find out the abnormal Pap smear causes. In some cases, cryotherapy, conization, laser therapy, hysterectomy or loop electrosurgical excision procedure (LEEP) can be recommended.

Interpretation of Abnormal Pap Smear Results

• Benign changes in cells can be a result of genital herpes, chlamydia, yeast infections, gonorrhea and estrogen decline in menopause. These conditions can lead to inflammation on cervix.
• The near-abnormal cells in the endocervical region or atypical glandular cells are considered benign.
• Some cells like ASCUS, atypical squamous cells, appear cancerous but they are rarely cancerous. But some of these cells require close monitoring, as they may lead to cancer in future.
• Dysplasia means abnormal cells. It is classified as mild, moderate, severe and carcinoma in situ, depending upon the cell abnormality.
• In mild dysplasia, only the superficial layer of cervix is affected. HPV can be the cause. In such cases, Pap smear should be repeated within 6 months.
• In moderate dysplasia, more number of abnormal cells are detected.
• Severe dysplasia needs further examination with other procedures as it is spread to the deeper parts of the tissues, developing as invasive cervical cancer.
• In carcinoma in situ, cancerous cells are found confined to the surface of the cervix. As they are detected before they spread to the deeper tissues, it becomes easy to treat the cancer.

It should be noted that women vaccinated against HPV also need to undergo Pap smears. Sexually active women over the age of 21 years should undergo the test every year. It is an easy procedure, helpful for maintaining women's health. A significant improvement in the survival rate for the cancer and an increase in the life expectancy of cervical cancer patients has been noticed, as the test helps detect the cancer at an early stage.

About 80% of the times, Pap smear results are reliable. But as the results can be false positive or false negative in some cases, Pap test should be repeated within a year. This way, missing abnormalities from the previous test can be detected during the next test. New methods are being developed to improve the accuracy of Pap tests.