Abnormal Pap Tests: What Do They Mean and What Comes Next?

At Complete Healthcare for Women, we are committed to providing you with the information and support you need to understand your results and the next steps in your care.

What is a Pap Test?

A Pap test, or Pap smear, is a routine screening procedure used to detect changes in the cells of the cervix. The goal is to identify any abnormal cells that might develop into cervical cancer if left untreated. Regular Pap tests are crucial for early detection and prevention of cervical cancer.

Understanding Abnormal Pap Test Results

Abnormal Pap test results indicate that some of the cells on your cervix have shown changes. These changes are often caused by the human papillomavirus (HPV), a common sexually transmitted infection. Here’s what different types of abnormal results might mean:

1. Atypical Squamous Cells of Undetermined Significance (ASC-US): This is the most common abnormal finding. It means that the cervical cells look slightly abnormal but it's unclear whether the changes are due to HPV infection or other factors.

2. Squamous Intraepithelial Lesion (SIL): This term indicates that there are changes in the cervical cells that could be precancerous. SIL can be low-grade (LSIL) or high-grade (HSIL). LSIL usually suggests mild changes, often linked to HPV infection, while HSIL indicates more serious changes that are more likely to be precancerous.

3. Atypical Glandular Cells (AGC): These changes occur in the glandular cells that line the cervical canal. AGC results can be more concerning and require further testing.

4. Cervical Intraepithelial Neoplasia (CIN): This grading system is used to describe the severity of abnormal changes. CIN is graded on a scale of 1 to 3, with CIN 1 indicating mild dysplasia and CIN 3 indicating severe dysplasia, which is the most serious and closest to becoming cancerous.

Next Steps After an Abnormal Pap Test

If your Pap test results are abnormal, your healthcare provider will recommend further testing to determine the cause and extent of the abnormal cells. These follow-up procedures may include:

1. HPV Testing: An HPV test can identify whether high-risk types of HPV are present in your cervical cells. This test is often done at the same time as a Pap test.

2. Colposcopy: During a colposcopy, your healthcare provider uses a special magnifying instrument called a colposcope to closely examine your cervix. This procedure is similar to a Pap test and can help identify abnormal areas that need further investigation.

3. Biopsy: If abnormal areas are found during the colposcopy, a small sample of tissue may be taken (biopsy) and examined under a microscope to determine the extent and severity of the cell changes.

4. Endocervical Curettage (ECC): This procedure involves scraping cells from the cervical canal to check for abnormalities.

Managing Abnormal Pap Test Results

Treatment options depend on the severity of the abnormal changes and may include:

1. Watchful Waiting: Mild abnormalities, such as ASC-US or LSIL, often resolve on their own. Your healthcare provider may recommend repeat Pap tests or HPV testing at regular intervals to monitor the changes.

2. Cryotherapy: This procedure involves freezing abnormal cells to destroy them.

3. Loop Electrosurgical Excision Procedure (LEEP): A thin wire loop with an electric current is used to remove abnormal tissue.

4. Cone Biopsy: A cone-shaped piece of abnormal tissue is removed from the cervix for examination.

Conclusion

Receiving an abnormal Pap test result can be worrying, but it’s important to remember that it doesn’t necessarily mean you have cervical cancer. Early detection and treatment of abnormal cells can prevent cervical cancer from developing. At Complete Healthcare for Women, we are here to guide you through every step of the process, providing expert care and support.

For more information or to schedule a consultation, contact us:

Complete Healthcare for Women - Obstetrics and Gynecology
509-392-6700
Richard Lorenzo, D.O.
Kortney Jones ARNP

Author

Richard Lorenzo, DO Dr. Lorenzo is also a Fellow of the American Congress of Obstetricians and Gynecologists and a Fellow of the American College of Osteopathic Obstetricians and Gynecologists. He provides gynecological and obstetric services, including prenatal care, pregnancy care, infertility, and gynecology. Dr. Lorenzo is proficient in advanced surgical techniques, including minimally-invasive procedures, as well as surgery for abnormal uterine bleeding, endometriosis, and hysterectomy. He has specialized training in high-risk obstetrics and minimally invasive surgical techniques, including minimally invasive hysterectomy.