Pap tests are designed to screen for changes in the cells of the cervix, which can indicate that cervical cancer is likely to develop or has already begun developing. Because cervical cancer is a slow-growing cancer, early diagnosis is important in treatment and prevention. Women who are sexually active or over the age of 18 should get annual pap smears as a preventative measure against cervical cancer. An abnormal result may indicate that cell changes are occurring that need to be treated or that have already occurred that need medical attention in order to prevent cancer.
Pap Test Results
Most labs in the United States use a system called the Bethesda System in order to classify pap test results. A normal result in a pap test indicates that the cervix is free of infection or cell changes and that a woman can continue to have routine pap test screenings. Other classifications are used to describe the type of abnormal result and to make treatment decisions. Other classifications include atypical squamous cells (ASC or ASC-US), low-grade squamous intraepithelial lesions (LSIL), high grade squamous intraepithelial lesions (HSIL), atypical glandular cells or cancer.
Atypical Squamous Cells
An abnormal pap test result classified as ASC or ASC-US is relatively inconclusive. It may indicate a minor or mild infection or irritation or may indicate that sexual intercourse recently occurred. However, it might also be indicative of pre-cancerous changes. Because this result can indicate many different things, further testing is usually required. Some doctors simply recommend a repeat pap smear in four to six months. Other doctors will do an HPV test to check for high risk strains of HPV. If high risk strains of HPV are discovered on the HPV test, a doctor will usually do a colposcopy. This involves using a tube called a coloscope to look into the cervix and look for the presence of abnormalities.
Squamous Intraepithelial Lesion
There are two types of SIL classification--low grade (LSIL) and high grade (HSIL). Low-grade SIL can indicate that precancerous changes were apparent in the cells. However, these low-grade changes can sometimes go away on their own, so doctors may simply recommend a repeat pap smear in four to six months. High-grade SILs indicate that moderate or severe precancerous cell changes were observed. The doctor will generally do a colposcopy to observe the extent of the abnormality, and cyrosurgery (freezing) or laser surgery (burning) may be used to kill the abnormal cells. Fertility is normally not affected by these procedures.
Atypical Glandular Cells
Atpyical glandular cells are indicative of the development of invasive squamous cell cancer. Further testing, including a colposcopy and usually a biopsy, are recommended to determine if the cells are cancerous and to determine the extent of the cancerous cells in the cervix.
Cancer
The presence of cancer cells suggest that the patient has cervical cancer. The patient should be referred to an oncologist to formulate a treatment plan, based on the stage of the cervical cancer and the extent of severity.
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