Abnormal Pap smear

Women are advised to start having a Pap test every year at age 21 or within 3 years of becoming sexually active. Pap smears are not diagnostic tests, but they are screening tools used to detect abnormal cells or dysplasia in the cervix.

When women get regular Pap smears, they increase their chances of early detection and treatment of any potential problems.

What does an incorrect Pap test mean?

Anxiety or worry is a perfectly normal reaction when you are told that your Pap test is not normal. An abnormal Pap test may indicate that you have an infection or abnormal cells called dysplasia. It is important to remember that an abnormal Pap test result does not mean you have cancer.

These results just show that more tests need to be done to see if there is a problem.

What can cause an abnormal Pap smear result?

An abnormal Pap test may indicate any of the following:

An infection or an inflammation
Herpes
Trichomoniasis
Recent sexual activity
HPV (Human Papilloma Virus) This is also called genital warts (up to 60% of women may carry this virus on their cervix, genital area, or skin and are completely unaware of it).
Dysplasia (abnormal cells that can be pre-cancerous)

What is the treatment for an abnormal Pap test?

A positive result indicates the presence of abnormal cells, also called abnormal smears. Remember that this is a test, not a diagnosis. A positive result does not prove that you have cancer or even dysplasia (a precancerous condition).

However, this usually means that you should have additional tests, such as another Pap test, a colposcopy (using a microscope to look at your cervix), or a biopsy (removing a small amount of tissue from your cervix). Your doctor will discuss the results with you.

One in ten Pap tests will indicate an abnormality, although most are not serious. Additional tests will be needed to determine if you have an infection, inflammation, yeast infection, trichomoniasis, herpes, or human papillomavirus (HPV).

HPV is a major risk factor for cervical cancer, but most women treated for abnormal cells caused by HPV do not develop cervical cancer.

Some Pap smears indicate an unsatisfactory sample due to recent sexual activity or use of vaginal creams and douches. Whatever the reason, an abnormal Pap smear will require a second Pap smear after a few months.

If abnormal cells persist, you may need further treatment, which may include the following:

A colposcopy is an examination in which a speculum is inserted into the vagina and the cervix is stained with a vinegar solution to reveal any abnormal areas. When an abnormal area is found, the pathologist may take a sample (biopsy) of the area for an accurate diagnosis.

Cryosurgery, or freezing of the abnormal cells, is usually then performed. A cone biopsy is a procedure that removes a triangle of cervical tissue, including abnormal cells; this is done either in a doctor's office or as an outpatient. Bleeding and watery discharge are common after this treatment.

What checks are needed after treatment?

Check-ups after treatment are necessary to make sure that all abnormal cells have disappeared and the cervix has healed. Early detection is the key to minimizing the risk of developing cancer. After treatment, the health care provider will tell women how often they need to have routine Pap smears.

What should I do if I have an abnormal Pap smear during pregnancy?

It is safe to have a Pap smear during pregnancy. If the Pap test results are not normal, a colposcopy may be done during pregnancy. However, further treatment is likely to be delayed until the baby is born.

Often, the birth of your baby eliminates all of the abnormal cells in the cervix. An abnormal Pap test is not dangerous for your child.