Abnormal Pap Smears

Regular pap smear testing is the best screening method for early diagnosis and cure of cervical cancers that would go undetected otherwise. Abnormal pap results would be an add-on for diagnosing cancer and not a substitute for pelvic examinations in any way.

What is a Pap Smear?
A pap smear or a pap test is process where the cells of the cervix are collected in an attempt to find early cancerous changes or other signs of inflammation. Women who are sexually active and over the age of 21 years are recommended pap smear testing every year.

What are High-risk Factors causing Abnormal Pap Smears?

• Human papilloma virus (HPV) infection
• History of sexually transmitted illness like herpes and gonorrhea
• Sexually active and not using protection
• Family history of cancer-cervix
• Sex with more than one partner
• Smoking and tobacco use

What do abnormal pap smears mean?
Abnormal pap smear basically means there are some unnatural changes in the cervical cytology and pap test is said to be "positive". Your health care provider would exactly interpret to you the exact reason for cell changes. The importance of a positive pap result can be understood by the type of cells seen which decides the possible treatment later.

Abnormal Pap tests are interpreted as follows:

1. Benign Changes in Cells
Genital herpes, chlamydia, yeast infections, gonorrhoea and estrogen decline in menopause are conditions displaying signs of inflammation on cervix.

2. Stages of Precancerous and Cancerous Cervical Cells

• Atypical squamous cells also known as ASCUS shows cell abnormalities resembling cancer but isn’t cancer. Doctors are unsure of why those changes occur and what they mean.
• A small percentage of Atypical squamous cells can however be classified as ASC-H which means they should be closely monitored considering a furture possibility of cancer.
• Atypical glandular cells are the near-abnormal cells in the endocervical region, considered benign.
• Dysplasia means abnormal tissue and not essentially cancer. It is classified as per the degree of cell abnormality.
• Mild dysplasia(CIN I): Only the superficial layer of cervix is affected and maybe caused by HPV virus. Pap smear should be repeated within 6 months.
• Moderate dysplasia(CIN II): Comparatively more number of abnormal cells are seen
• Severe dysplasia(CIN III): Changes in the cells definitely needs further assessment with another procedure It spreads to the deeper tissues and progressing into invasive cervical cancer.
• Carcinoma in situ(AIS): Cancerous cells are confined to the surface of the cervix and have not spread to the deeper tissues. Colposcopy and biopsy is a must in CIN II and CIN III cases. Advanced cases of cancer necessitate treatment with LEEP, hysterectomy, laser therapy, and cryotherapy.

Squamous intraepithelial lesion (SIL) is another way of addressing the degree of precancerous changes in cells. Low-grade SIL refers to the mild dysplasia(CIN I) described above. High-grade SIL refers to moderate or severe dysplasia (CIN II or CIN III) and adenocarcinoma in citu described above.

How reliable are the Abnormal Pap Results?
Test results are reliable around 80% times. Sometimes it may show false positive or false negative results. That’s why smear tests should be repeated within a year to avoid missing any abnormalities that couldn’t be detected in the previous test. To achieve a greater accuracy of results the test should be conducted keeping a few things in mind. Test should not be done around the menstruation. No deodorants, sprays, birth control jellies and avoid sex for 48 hours before a pap smear. Other reasons for wrong results would be lesser number of abnormal cells or a small lesion.