Evaluating an Abnormal Pap Test

PAP-EvaluationMore than 50 million Pap tests (previously called a Pap smear) are performed each year in the U.S., and in about 5 percent of tests, abnormal or unusual cells are discovered. This is called a positive result.

If your Pap test has a positive result, please don’t panic! This doesn’t necessarily mean you have cervical cancer. What it does mean depends on the type of cells found in your Pap smear.

 

What Abnormal Pap Test Results Can Mean

These are the most common terms used to describe abnormal Pap test results:

  • Atypical squamous cells of undetermined significance (ASCUS) – This is the most common abnormal Pap test result. “Squamous” refers to the type of cells that make up the tissue that covers the cervix. ASCUS means that changes in these cells have been found; this is almost always a sign of a human papillomavirus (HPV) infection, although it can indicate a pre-cancerous condition.
  • Squamous intraepithelial lesion (SIL) – This means that abnormal changes are seen in the cells and may be a sign of pre-cancer. SIL can be low-grade (LSIL) or high-grade (HSIL).
    • LSIL is very common, almost always indicates an HPV infection and usually goes away on its own without treatment (but may also indicate mild pre-cancerous changes)
    • HSIL indicates more serious changes. Carcinoma in situ (CIS) is a severe form of HSIL and most likely to progress to cancer.
  • Atypical squamous cells, cannot exclude HSIL (ASC-H) – Testing has found changes in the cervical cells; these changes aren’t clearly HSIL but could be, and further testing is needed
  • Atypical glandular cells – This means that cell changes are seen that suggest pre-cancer of the upper part of the cervix or uterus
  • Cancer – Abnormal cells may have spread more deeply into the cervix or other tissue

 

What Else Can a Pap Test Find?

Sometimes a Pap test will reveal:

  • Endometrial (uterine) cells – These can be normal or abnormal, but even normal endometrial cells shouldn’t be present after menopause.
  • Infections – Sometimes the pathologist reviewing the Pap test will see bacteria, yeast or other signs of infection.

 

What Happens If My Pap Test Is Abnormal?

It depends on your age and the type of abnormality that’s found. The most common follow-up is a repeat Pap test and HPV testing.

Your doctor may also perform an in-office procedure called a colposcopy to help make a more precise diagnosis.

If there’s concern about abnormal glandular cells or endometrial cells, your doctor may recommend an endometrial biopsy.

 

Questions about abnormal Pap test results?

The physicians and staff at Women’s Health are here to provide answers. Simply contact us.