Overview Of Abnormal Pap Test
A pap smear is another name for a pap test, which detects cervical cancer. The cervix is located at the very top of the vagina. It opens to the lower section of the uterus. This test involves scraping cells off of the opening of the cervix, then examining them under a microscope. If abnormalities are present, it is an abnormal pap test.
Commonly Associated With
Squamous Intraepithelial Lesion Pap Test, Cervical Cancer Screening Pap Test or Pap Smear, and Human Papilloma Virus (HPV) Pap Cervix Test.
How The Test Is Performed
The exam begins with the patient reclined on the exam table with their feet placed in stirrups. Your health care provider then carefully inserts a speculum (a device designed to allow a physician to inspect the inside of various body openings) into the vagina so that they may see into the area. A sample collector gently scrapes cells from the cervix area. They are then sent to a lab for examination with a microscope.
How to Prepare for the Test
Inform your physician about any and all medications you are currently taking. Some birth control pills that contain progestin or estrogen may influence test results.
Also Inform Your Provider If You:
- Could be pregnant
- Have had a previous abnormal Pap test in the past
DO NOT Do The Following For 24 hours Before The Test:
- Have sexual intercourse
- Douche (do not douche immediately before a Pap test)
- Use tampons
Additional Advice Before the Test
Attempt to avoid scheduling the Pap test during times you know you will be menstruating. The test may be less accurate if blood interferes. If you are experiencing unexpected bleeding around the time your scheduled Pap test, you do not need to cancel your exam. Your health care provider determines if the Pap test will still be completed or not.
Make sure to empty your bladder before the test begins.
The Test Experience
A Pap test normally involves little to no discomfort for most people. It may cause a sensation similar to menstrual cramps, or a feeling of pressure at most. A small amount of bleeding after the exam is normal.
Why The Pap Test Is Performed
The Pap test’s main function is to screen for cervical cancer. If the patient has routine Pap tests done at regular recommended intervals, it is possible to detect most cervical cancers early.
Doctors recommend pap tests begin at age 21.
After The First Test:
- Perform pap tests at least every 3 years to screen for cervical cancer.
- Most people do not need to have Pap tests after the age of 65-70, so long as at least 3 of their previous tests have been negative over the last 10 years.
- Pap tests may be unnecessary in those who have had a total hysterectomy (cervix and uterus removed) and have never had cervical cancer, an abnormal Pap test in the past, or any other pelvic cancer. Discuss this with your provider first.
- You can be test every 5 years if you are over age 30 and have had normal Pap tests and HPV tests in the past. For reference, HPV (human papillomavirus) is a virus that can cause genital warts and cervical cancer.
In the case of a normal Pap test result, examination of the sample under a microscope does not show any abnormal cells. Unfortunately, the Pap test is not always 100% accurate. A small number of cases miss cervical cancer. Thankfully, cervical cancer typically develops very slowly. Follow-up tests are usually catch the cancer in time for effective treatment.
What Abnormal Pap Test Results Mean
Abnormal Pap Test Results Are Grouped As Follows:
ASCUS or AGUS:
- Atypical cells are present, but providers are uncertain or unclear what these changes in the cells suggest.
- The changes may be due to HPV, inflammation of an unknown cause, a lack of estrogen, (which typically occurs in menopause) or that these atypical cells could be precancerous, and could come from either inside the uterus or outside the cervix. These changes, whatever the cause, may lead to cancer.
LOW-GRADE DYSPLASIA (LSIL) OR HIGH-GRADE DYSPLASIA (HSIL):
- Changes that could lead to cancer are present in the sample.
- With the result of HSIL, the risk of progression to cervical cancer is deemed higher.
CARCINOMA IN SITU (CIS):
- The abnormal changes seen in the cells of the sample are likely to lead to cervical cancer if not addressed immediately.
ATYPICAL SQUAMOUS CELLS (ASC):
● Some abnormal changes in the cells have been observed, and HSIL may be suspected.
ATYPICAL GLANDULAR CELLS (AGC):
● Abnormal cell changes that could lead to cancer are observed either inside the uterus or in the upper section of the cervical canal.
You will need further follow-up and testing if abnormal cell changes are present on a Pap test. The next steps depend on the specific results of the Pap test, the patient’s previous history of Pap tests, and any risk factors the patient may have.. The next steps depend on the specific results of the Pap test, the patient’s previous history of Pap tests, and any risk factors the patient may have.
For minor cell abnormalities or changes, healthcare providers will recommend additional Pap tests or HPV screenings in 6 to 12 months.
Follow-up Testing Or Treatment May Include:
- An HPV test to check for which HPV virus types are present, as some are more likely to cause cancer than others.
- Colposcopy-directed biopsy – Colposcopy involves a binocular-like tool, known as a colposcope, which magnifies the cervix for better viewing. Small biopsies of the cervix area are often taken during the procedure so the abnormalities can be better quantified.
- Cone biopsy.
- Cervix cryosurgery.