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What Qualifies Pap Smear Results as Abnormal?
Cervical cancer was once the leading cause of cancer deaths among women. However, that’s changed over the last 40 years, primarily because of the Pap smear, or Pap test, now part of a routine well-woman exam.
The Pap test screens for precancerous cells that may turn cancerous and cancerous lesions. Detecting these cells early in their development means a greater chance of beating the disease.
Board-certified OB/GYN Dr. Hany H Ahmed in Houston, Texas, specializes in managing abnormal Pap smear results. An abnormal result doesn’t necessarily indicate cervical cancer. Here, Dr. Ahmed helps you understand what abnormal really means.
Performing a Pap smear
Dr. Ahmed performs Pap smears in his office, taking 10-20 minutes. This test generally is performed every three years, starting when a woman turns 21.
For women over 30, he may also test for human papillomavirus (HPV). It’s the most common sexually transmitted infection (STI) and is associated with cervical cancer.
Dr. Ahmed uses a swab to collect a sample of the cervical cells and sends the cells to a laboratory for review. He notifies you of the results.
What if your Pap smear comes back as abnormal?
The results come back as one of three things: negative for intraepithelial lesion or malignancy (no signs of cancer, precancerous cells, or other significant abnormalities), epithelial cell abnormalities, or other malignant growths.
If they come back as abnormal, it doesn’t necessarily mean you have cancer. Most often, abnormal results are due to changes in your cervical cells caused by HPV. Other potential causes include:
Atypical squamous cells of undetermined significance (ASCUS)
Squamous cells are thin, flat cells that grow on the cervix’s surface. ASCUS means the cells aren’t typical of healthy cells, but it doesn’t mean you have cancer.
Dr. Ahmed tests the cells to determine if HPV is present, as it’s a common cause. If it’s not, he may repeat the test or adopt a wait-and-see tactic.
Squamous intraepithelial lesion
These lesions may be precancerous, and they’re classified as low grade or high grade to describe their development.
Low-grade lesions might take years to turn cancerous or may be a sign of an HPV infection. If they’re high-grade, they can change much sooner. In both cases, Dr. Ahmed follows up with additional tests to determine the cells’ exact nature.
Atypical glandular cells
Glandular cells are found in the opening of the cervix and inside the uterus, where their function is to produce mucus. If they’re abnormal, they could be precancerous or cancerous; Dr. Ahmed follows up with more tests.
Squamous cell cancer or adenocarcinoma cells
If your cells are so atypical that Dr. Ahmed believes they're cancerous, he follows up with additional tests and coordinates care with an oncologist to treat the cancer before it can spread further.
What happens after an abnormal Pap smear?
What happens after you get abnormal results depends on how atypical the cells are. If they’re only slightly abnormal, Dr. Ahmed may perform a second Pap smear and/or an HPV test if he didn’t do one the first time. He may also order two other tests: a colposcopy and a biopsy.
A colposcopy is a deeper dive into the nature of the abnormal cells. He inserts a speculum into your vagina and views the cervix with a colposcope, a device with a bright light and a magnifying lens that allows him to see more detail than during a Pap smear.
He swabs the cervix with vinegar to highlight suspicious areas and uses the colposcope’s lens to get a closer and more detailed look at the cells.
If Dr. Ahmed finds areas that appear precancerous or cancerous, he takes a biopsy, a small sample of the tissue in question that he sends to the lab for further testing. The results are far more detailed than those from the Pap smear.
If the results indicate cells that warrant attention, Dr. Ahmed performs cryotherapy. He uses a device that freezes the abnormal tissue, which dies off. The tissue is eventually flushed from your body so it can’t harm you.
So, if your Pap smear comes back abnormal, don’t panic — there’s a good chance the cells aren’t cancerous.
Dr. Ahmed is specially equipped to interpret the results for you. Call our office to schedule a consultation, or book online today.
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