How to deal with an abnormal pap smear

If you hear from your doctor that you have an abnormal pap smear, one of your first questions will most likely be—how serious is it?

What is a pap smear?
A pap smear is a screening tool for cervical cancer. The procedure is done by your doctor with a tool that brushes across the surface of the cervix to collect cells, which are then analyzed. If you are a woman who takes care of your health, chances are you get a pap smear once a year. And you should, because in most cases if you go for a yearly pap smear you doctor will be able to catch anything abnormal before it becomes cervical cancer.

What is an abnormal pap smear?
An abnormal pap smear means that you have atypical cells or abnormal cells in your cervix. What needs to be determined is if any of the abnormal cells are pre-cancerous or cancerous cells. In some cases the abnormal cells can be secondary to inflammation or infection. For example, a very bad yeast infection that can alter the look of the cells. In that case, after treatment for the yeast infection, a repeated pap smear will most likely be normal.

Additional testing after an abnormal pap smear:

• Testing for the Human Papilloma Virus (HPV) is one way to help differentiate whether the abnormal cells are caused by an infection or if they are pre-cancerous. HPV is the virus that causes change in the cervix that lead to cervical cancer. If your doctor determines that you have HPV then your gynecologist will likely perform more extensive testing.

• A colposcopy is a more extensive type of test you may undergo. A colposcopy is a test using a colposcope, which presents a magnified view of the cervix. The magnified view enables your gynecologist to paint the cervix with acetic acid, which doesn’t burn or hurt. The acetic acid turns the abnormal cells white and a pinch biopsy can be performed. The biopsy is then analyzed to determine if there is a more serious abnormality involved than was initially detected on the pap smear.

The four types of abnormal pap smears:
There are ranges of abnormal pap smears. The mildest is called atypical squamous cells of undetermined significance. More serious abnormalities involve low-grade lesions (LGSIL) and high-grade lesions (HGSIL). The progression is atypical cells, low-grade lesions, high-grade lesions and then cancer. Often times, however, pap smears can miss certain lesions or the readings can be ambiguous. If your pap smear is ambiguous your doctor may suggest you get a pap smear every four to six months to ensure it’s not developing into a higher grade lesion.

If you have low-grade lesion, and you are a young, healthy woman with a healthy immune system, the abnormal cells may simply go away on their own. High-grade lesions, on the other hand, should be treated. You doctor may want to take out the portion of the cervix that looks abnormal. If you are diagnosed with cervical cancer there are various treatments available—surgical and radiation.