A Pap smear is a diagnostic tool that OB/GYN specialists use to detect abnormal cells or cancer in a woman's cervix. It's one of the preventive screening tools you should have regularly.
Many Pap smears come back normal, but some may come back unclear or abnormal, among other findings. Abnormal doesn't always mean cancerous, but it's a scary experience if you don't know what to expect.
If you're sexually active and have a menstrual cycle, you should be having a Pap smear regularly to screen for cancer and other dangerous changes in the cervix.
The team at New England Women's Healthcare offers Pap smears and other screening tools to help you stay ahead of your sexual health. Every member of our deep team of OB/GYN specialists enables you to understand your results and offers support through the next treatment steps.
What's an abnormal Pap smear?
A Pap smear is a test to screen for abnormal cervical cells that could indicate cervical cancer or an infection with the human papillomavirus (HPV). For the examination, we use a speculum to open your cervix and a small swab to collect tissue samples. We send these samples to a lab.
If the results return normal, the lab didn't find any abnormal cells in the cervix or surrounding tissues.
There are several reasons your Pap test may come back abnormal. According to the Centers for Disease Control and Prevention (CDC), a Pap smear can come back abnormal in three different formats, including:
An unclear result means it provides no clear answer. It means the results may appear abnormal, but there's no cut-and-dry reason for the type of cell or for the results.
For instance, you may get an unclear result back if you have an infection, are pregnant, or have been going through menopause.
An abnormal Pap smear result means the lab found abnormal-shaped cells in the cervix. However, it doesn't necessarily mean you have cervical cancer.
Abnormal cells may change back on their own if they're mild or could become cancer later. They could also be a sign you have HPV.
An unsatisfactory result means there weren't enough cells to test, or they were clumped in a way that wasn't conducive to testing. You may need to return in a few months for another Pap test.
Do I have cancer?
Although a Pap smear is a screening exam for cervical cancer, an abnormal Pap smear doesn't automatically mean you have it. Other than cancer, there are various reasons your Pap smear may come back abnormal.
In fact, according to the CDC, it's rare to have a Pap test come back positive for cervical cancer if you have regular screenings. A Pap test can find many types of abnormal cells, including:
- Atypical glandular cells
- Atypical squamous cells of undetermined significance (ASCUS)
- High-grade squamous intraepithelial lesions (HSIL)
- Low-grade squamous intraepithelial lesions (LSIL)
- Adenocarcinoma in situ
- Squamous cell carcinoma
Squamous cell carcinoma is the only result that signifies the presence of cancer in the cervix. We need further testing to ensure the cancer cells haven't spread to other areas. You may be referred to an oncologist to ensure you get fast and efficient treatment.
The other types of cells may indicate various problems, including HPV, infections, or precancerous changes. More testing is usually necessary to rule out serious issues.
The following steps in treatment
After you receive the news of an abnormal Pap smear, our office staff schedules you for a follow-up appointment. At the meeting, our team discusses the results with you and talks about the next steps.
In some cases of mild changes, we may closely monitor your health and perform another Pap test in a few months. Some cell changes return to normal, especially after an infection or hormonal changes.
For more significant cellular changes, we may suggest performing a test called a colposcopy. During a colposcopy, our team uses a specialized tool called a colposcope to look at the tissues in the vagina and cervix carefully.
They take a tissue sample and send it off for a definitive diagnosis if they find suspicious-looking tissues. You should receive the results in about a week from the time of the colposcopy.
We can treat results that indicate mild to moderate changes by watching them and performing regular Pap tests and repeat colposcopies if necessary.
We should address more concerning changes immediately and suggest a loop electrosurgical excision procedure (LEEP) or a cold knife conization. These procedures remove the irregular tissue to ensure cancer cells don't grow from the abnormal cells.
To schedule your next Pap smear, call our team at our Woburn or Wilmington, Massachusetts, offices or request an appointment on the website.