Women are encouraged to start getting yearly Pap smears at the age of 21 or within 3 years of becoming sexually active. Pap smears are not diagnostic tests, but they are screening tools used to find any abnormal cells or dysplasia in the cervix. When women are faithful in having regular Pap smears, they increase their chances for early detection and treatment of any potential problems.
What does an abnormal pap smear mean?
Being alarmed or worried is a completely normal reaction when told your Pap smear is abnormal. An abnormal Pap smear may indicate that you have an infection or abnormal cells called dysplasia. It’s important to remember that abnormal Pap smear results do not mean you have cancer.
These results just show that further testing should be done to verify whether or not there is a problem.
What could cause an abnormal pap smear result?
An abnormal Pap smear may indicate any of the following:
- An infection or an inflammation
- Recent sexual activity
- HPV (Human Papilloma Virus) This is also called genital warts (up to 60% of women may carry this virus on their cervix, genital area, or skin and are completely unaware of it).
- Dysplasia (abnormal cells that can be pre-cancerous)
What is the treatment?
A positive result indicates the presence of abnormal cells, also called an abnormal Pap. Remember that this is a test, not a diagnosis. A positive result does not prove that you have cancer or even dysplasia (a pre-cancerous condition).
However, it usually means you should have further evaluation, such as another Pap smear, a colposcopy (using a microscope to look into the cervix) or a biopsy (removing a small amount of tissue from the cervix). Your doctor will discuss the results with you.
One in ten Pap smears will indicate some abnormality, though most are not serious. Further testing will be required to determine if you have an infection, inflammation, a yeast infection, trichomoniasis, herpes or the Human Papilloma Virus (HPV).
HPV is the main risk factor for cervical cancer, but most women who receive treatment for abnormal cells caused by HPV, do not develop cervical cancer.
In 2003, the FDA approved a screening test that can be done in conjunction with a Pap smear to determine if you have the HPV virus. The HPV DNA test can detect high-risk types of HPV before any abnormal cells can be detected on the cervix. This screening is recommended for women over the age of 30, who are at an increased risk of an HPV infection turning into pre-cancerous cells.
Some Pap smears indicate an unsatisfactory sample because of recent sexual activity or use of vaginal creams and douches. Regardless of the reason, an abnormal Pap will require another Pap smear in a few months.
If the abnormal cells are persisting, you may need further treatment, which may include the following:
- A colposcopy is an examination in which a speculum is inserted into the vagina, and the cervix is painted with a vinegar solution which makes any abnormal areas stand out. When an abnormal area is located, a sample (biopsy) of the area may be taken for accurate diagnosis by a pathologist.
- Cryosurgery, or freezing of the abnormal cells, is usually performed next. Cone biopsy is a procedure in which a triangle of cervical tissue is removed including the abnormal cells; this is either performed in a doctor’s office or as an outpatient procedure. Bleeding and watery discharge are common after this treatment.
- The LEEP procedure is similar to a cone biopsy, but a loop-shaped instrument is used to remove the abnormal area. Bleeding and discharge may also occur.
What check-ups are necessary after treatment?
Check-ups following treatment are necessary to make sure all the abnormal cells are gone and the cervix has healed. Early detection is the key to minimize the risk of cancer developing. After treatment, women will be advised by their health care providers as to how often they will need to have routine Pap smears.
What if I have an abnormal pap smear during pregnancy?
It is safe to have a Pap smear during pregnancy. If your Pap smear results are abnormal, a colposcopy could be performed during your pregnancy. However, further treatment will probably be delayed until after your baby is born.
Frequently, the birth of your baby will wash away any abnormal cervical cells. Having an abnormal Pap smear does not pose a risk to your baby.
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Compiled using the following sources:
Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R,et al, Ch.53