If your doctor recently informed you that you had abnormal pap smear results, don't hit the panic button quite yet. Most abnormal pap smears tend to reveal other, minor underlying conditions that caused changes in your cervical cells. Although there's a chance that your results may be something more serious, early detection combined with prompt follow up treatment can lower your risk of those cell changes developing into cancer.
Best Pap Practices
Identifying abnormalities in cervical cells is one of the most reliable ways to assess a woman's risk for developing cancer as well as diagnosing existing cervical cancer. It's recommended that all women begin having annual pap smears from the time they become sexually active until about age 65, although some doctors will okay bi-annual tests for women between the ages of 30 and 65 who have an uninterrupted history of normal test results. (If you have questions about the frequency of your tests, ask your doctor what he or she thinks is the best course of action for you).
Although pap smears can be taken during menstruation, it's best to schedule yours10 to 20 days after the first day of your menstrual period. Other variables that could result in false abnormalities include the use of vaginal suppositories, creams or douche within two days of your scheduled exam. You should also avoid sexual intercourse during these two days as well.
Understanding Your Results
Pap smear results are coded using the Bethesda System. Normal test results are generally listed as "negative for intraepithelial lesion or malignancy." Abnormal test results are categorized as follows:
Atypical squamous cells - US (ASC-US). The cells aren't completely normal, but the changes are minor, but what those changes mean cannot be determined from these results alone. Can be caused by the Human Papilloma Virus (HPV). These cells are located on the flat surface of the cervix opening.
Atypical squamous cells - H (ASC-H). Similar to ASC-US cell abnormalities, but carry a higher risk of being precancerous.
Atypical Glandular Cells (AGC). These cells are located in the opening in the center of the cervix and/or the uterine lining. This result means there are changes in the cells, but the results are not definitive enough for diagnosis.
Endocervical Adenocarcinoma in Situ (AIS). Precancerous cells found in the glandular tissue.
Low-grade Squamous Intraepithelial Lesion (LSIL). These results indicate early-stage changes in the size and shape of cervical cells. These abnormalities are considered minor and are usually related to HPV.
High-grade Squamous Intraepithelial Lesion (HSIL). The change in cell size and shape are no longer early stage. These abnormalities are more severe than LSIL and carry a higher risk of progression to invasive cancer.
One of the most common causes of changes in cervical cells and cervical cancer itself is the Human Papilloma Virus. However, HPV is actually a general term used to describe any one of more than 100 viruses, only 40 of which are transmitted sexually, and of those 40, only a subset cause cervical cancer.
Regular pap smears will give you your best chances at early detection of cervical cancer, but results many not be 100% accurate. Abnormalities can be caused by cancer or HPV, but also from infection, the use of contraceptive cervical caps and diaphragms and even aging.
Follow Up Treatments
Consult with your doctor about the course of action he or she thinks is best suited to your individual test results. Common follow-up tests are ordered first to confirm the original results and then determine the best treatment.
Second pap smear. Often, the first action taken is a second pap smear test to confirm the initial results. If the second test comes back normal, your doctor may schedule follow-up pap smears at three-month intervals until consecutive normal results are obtained.
Colposcopy. If your second pap smear still returns abnormal results, this procedure involves staining the cervix with a special dye that enables your doctor, with the aid of a high-power microscope, to better view the cell abnormalities and how widespread they are.
Endocervical curettage and biopsy. If your colposcopy reveals cell changes that are cause for concern, your doctor may remove a small sample of your cervical cells to be evaluated by a pathologist. If these results indicate cancer, your doctor will discuss the various treatment options available to you.
Although cervical cancer is a real threat to women, receiving abnormal pap smear results is not a cancer diagnosis and about half of all abnormal results are minor in nature. The most important thing you can do is have regular pap smears as part of ongoing preventative care and work with your doctor to determine the root cause of any cell abnormalities that develop.
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