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Abnormal Pap smears

Most labs use the “Bethesda System” to describe Pap test results.  This standardized system helps doctors follow treatment plans.

Normal (negative) - Only normal cell are seen.

Atypical Squamous Cells of Undetermined Significance (ASCUS) - Some cells seen that can be called normal do not have the requirements to be called precancer.  The abnormal cells may be caused by infection, irritation, intercourse, or starting or finishing your period or may be precancerous.  With this Pap smear, we need to repeat it again in 3-6 months.

Squamous intraepithelial lesion (SIL) - Normal cells of the surface of the cervix are replaced by a layer of abnormal precancerous cells. SIL is classified as low or high grade.  Sometimes, SIL  is also referred to as dyplasia.

Low-grade SIL (LSIL)/ mild dysplasia - Early changes are seen in the cells.  Often, mild dysplasia will revert back to normal.

High-grade SIL(HGSIL) - Can be further categorized in worsening severity from moderate dysplasia , severe dysplasia, or carcinoma in situ (CIS).  The changes here with these cells suggest an increased risk of precancer than LGSIL changes.

Atypical glandular cells - Cell changes that represent an abnormality that needs to be evaluated more closely.  Evaluation depends on your age and other factors. 

HPV (human papillomavirus) is a group of viruses linked to cancer in both men and women.   This virus is a sexually transmitted virus, meaning it can be passed from person to person through sexual (oral, anal or vaginal) contact. 

Of the more than 100 subtypes of HPV, many are benign.  Some subtypes are linked with genital warts, while others are associated with precancerous lesions or cervical cancer.  HPV has also been linked to cancer of the anus, vulva, vagina, penis, and throat.  HPV is very prevalent; 3 out of every 4 people will get an HPV infection during their lifetime.  Most women with HPV do not develop pre-cancer of the cervix.  Most of the time, the abnormal cells go away without treatment.  In some cases, these cells may progress to pre cancer or cancer.  Cervical cancer develops over a long period of time.  In some cases, an HPV test can be done. 

During your regular Pap test, the cells obtained can also be tested for the HPV virus.  A negative HPV test result means the cell changes are not related to pre-cancer. Women with a positive test for the high-risk HPV will need further testing. 

Currently, there is no cure for HPV.  You can decrease your risk of getting HPV by avoiding contact with the virus by limiting your number of sexual partners and using condoms.  By not smoking, you can help your immune system fight the virus. Get regular Pap smears.  Cervical cancer can be prevented with early detection and treatment.

Follow-up

Sometimes, your doctor will want to follow you with just a simple repeat Pap test.  Other times, you may need a colposcopy and biopsy, or LEEP procedure.