Table of Contents
Abnormal Pap Smear: What You Need to Know About It
Today, cervical cancer is the 4th most common type of cancer in women. Cervical cancer can be tested when a woman has an abnormal Pap smear and may be discovered during a routine physical examination.
It is best to know more about what happens when we neglect an abnormal Pap smear. That’s why in this article, we will talk about Pap smears and the complications that come with them if an individual has an abnormal result.
What Is a Pap Smear?
A Pap (Papanicolaou) smear is another term for Pap test or cervical cytology. It’s a procedure that accumulates cervical cells and monitors changes caused by HPV or Human Papillomavirus that lead to cervical cancer if ignored.
HPVs are a cluster of related viruses that you can get through sexual intercourse. High-risk HPV types are the primary cause of cervical cancer. They are also the root cause of some cancers in the vagina, anal area, and throat cancer.
In some cases, a Pap smear can also detect other infections. This cervical screening test will help the doctor see if there are abnormal changes in your cervical cells and provide the necessary care treatment to prevent diseases.
Who Needs to Take a Pap Smear?
Due to research findings, cervical screening recommendations have been considered for women. Many organizations, such as the American Cancer Society, support these recommendations. As women have invasive cervical cancer, the ACOG or American College of Obstetricians and Gynecologists suggests that the following age intervals of women must be met:
- Those from ages 21-29 must take a Pap smear every after three years.
- Those from ages 30-65 must get a Pap smear with an HPV test every after five years.
- Other women with other medical conditions such as AIDs or with a history of cervical issues need testing as well.
What to Expect When Taking a Pap Smear?
A Pap smear or Pap test is generally done in a pelvic exam and only lasts for a few minutes.
This is how the procedure will go:
- In this exam, you need to lie on your back on the provided examination table.
- Bend your knees and place your feet at the end of the table for some support.
- A speculum will be used to open the vagina to have a closer look at the cervix.
- The doctor will use a tiny soft brush to gather small needed samples of cervical cells.
- Afterward, the sample of your cervical cells will be sent to a lab where it will be checked and evaluated to locate infections.
Where Can You Get a Pap Smear or Cervical Cancer Screening?
There are community health centers, hospitals, and doctor’s offices that provide cervical cancer screening services such as Pap smears. If you don’t have a trusted doctor in your area, you can search for a clinic that offers this screening type.
You can also ask your local health department or state medical centers if they provide cervical cancer screening services.
Pap smear is done by obstetrician-gynecologists (OB-GYNs) or by significant care physicians such as internal-medical specialists or family practitioners. Other specially trained health care providers such as nurse-midwives and nurse practitioners can also perform Pap smears.
What Are the Three Results?
There are three Pap smear results: normal, abnormal, and unsatisfactory.
A normal test result, also called a negative result, shows that there’s no room for malignancy or intraepithelial lesion. If you only take a Pap smear, your next screening would be after three years.
If you take the Pap smear together with the HPV test and you get a negative result, you don’t need to retake the test for another 5 years. But if it turns out to have an abnormal result, then you need to retake the test earlier than the five-year interval.
In an abnormal Pap smear, there are visible abnormal changes in the cervix area. There are potential abnormal findings such as ASC-US, LSIL, AGC, AIS, ASC-H, HSIL, or worse; the result leads to cervical cancer.
Follow-up tests need to be done to treat the abnormal changes in the cervical cells and prevent invasive cervical cancer that can affect one’s life.
For the unsatisfactory Pap smear result, the cause is from not having enough samples of cervical cells. You will need to go through another screening process in the next 4 months.
Pap smear results often take at least 13 weeks, so be patient while waiting. If there’s no news from the health care provider, you can personally ask and call them for the Pap test results. Make sure to read and understand the results with much attention.
You can ask them if you need to undergo follow-up check-ups or there is a need for major treatment. Be open with your doctor if you don’t understand some information on the results given to you.
Why Might Abnormal Smears Need Treatment?
As the population of women who have cervical cancer grows, knowing that one of the major factors of having it is an abnormal Pap smear is important. Though getting an abnormal Pap test result may not automatically identify you as a cancer patient, it’s better to aid an immediate remedy for these underlying concerns.
What Is an Abnormal Pap Smear?
If the doctor found out that you have an abnormal Pap test, it means some of your cervical cells don’t look normal.
A Pap smear is usually done in a woman’s physical exam for the prevention of cervical cancer. Even though you have an abnormal Pap test, it doesn’t mean that you already have cancer. As a matter of fact, there’s only a little chance for it to develop into cervical cancer.
What Causes an Abnormal Pap Smear?
The major cause of abnormal cervical cell changes is HPV or Human Papillomavirus, a sexually transmitted infection. These certain types of HPV are mostly connected to severe cervical issues, so taking a regular Pap smear is recommended.
Though some types of infection, like yeast infections, cause abnormal changes, you can still undergo treatment for them. In some cases, cell changes found in a Pap smear happen to women in their menopausal stage.
What Causes Abnormal Cervical Cells?
If you have an abnormal cell in your cervix, it means that there are changes in the neck of the womb or the cervix, which the cells cover. These changes are not cancerous. They can make their own features go back like normal. However, if not given enough attention, it may lead to severe problems such as cervical cancer in no time.
The screening result provides the type of changes that happen to cervical cells. It’s either a low grade or high grade. Low-grade means there are only minimal abnormal changes while high-grades show severe or moderate abnormal changes of the cervical cells.
What Are the Symptoms of Abnormal Cell Changes?
HPV doesn’t cause symptoms of abnormal cell changes even though they are the reason for having an abnormal Pap smear.
However, if the reason for the abnormal Pap test is from a distinctive sexually transmitted infection, then the following symptoms may occur:
- A change in vaginal discharge, such as the odor, color, texture, and amount
- Pain and burning in the genitals when urinating or during sex
- Rashes, sores, or lumps near or around the genital area
Risk Factors of Abnormal Results
Most of the time, HPV is the root of having an abnormal smear result. Aside from that, the following factors are also included:
- An impaired and weak immune system
- Some particular sexual behaviors such as unprotected sex and sex orgy
- Exposure to the drug DES during your mother’s pregnancy (a rare case)
What Are the Findings of an Abnormal Pap Smear?
If you have an abnormal Pap smear result, this means that result is positive. Abnormal Pap test findings include:
ASC-US or Atypical Squamous Cells of Undetermined Significance
Atypical Squamous Cells of Undetermined Significance or ASC-US is the most popular finding in abnormal Pap tests. These thin, flat squamous cells propagate on a healthy cervical surface. In this finding, the cervix cells are not completely normal, but it’s not confirmed if the HPV infection is the cause of the changes. Some of the reasons that lead to cells looking abnormal are irritation, infection, polyps’ growth in the uterus, and when women undergo the menopause period.
This result may not be related to cancer even though you have abnormal cervical cells. The health care staff makes you take an HPV test to check if the HPV infection is the leading cause of these changes. If you have a negative HPV test, a prescription of estrogen cream will follow to check if the cells undergo changes because of low hormone levels. If you have a positive HPV test, then follow-up tests will need to take place. If there’s no evidence of HPV’s presence, then there’s no need to worry at all.
AGC or Atypical Squamous Cells
Atypical squamous cells produce mucus and can be found in the cervical openings and inside the uterus. For the findings of atypical glandular cells or AGC, some glandular cells are found to look abnormal. It becomes a sign of a more severe problem in the uterus area. Once it happens, as prescribed by the health care provider, you must come back again for a schedule of colposcopy.
LSIL or Low-Grade Squamous Intraepithelial Lesions
Low-grade squamous intraepithelial lesions or LSIL show that an HPV infection is a usual cause of having low-grade changes in the cervical cells. Around 30% of women experience this finding, which leads to a more severe abnormality of the cervix once biopsy is done. An additional test is manifested to make sure that no more high-grade changes occur.
ASC-H results from a high-grade squamous intraepithelial lesion (HSIL) on some abnormal squamous cells. Though it is not definitive of cancer, you need to get a schedule for colposcopy.
HSIL or High-Grade Squamous
High-grade squamous intraepithelial lesions or HSIL are risky findings. If not given an immediate response of treatment, the moderate number of abnormal cervical cells can lead to cancer. A colposcopy is needed.
AIS or Adenocarcinoma in Situ
Adenocarcinoma in situ or AIS shows abnormal growth in an advanced lesion on the cervix located in the glandular tissue. AIS lesions are in the pre-cancer phase, but if not treated, it could lead to cancer of the cervix or cervical adenocarcinoma. Listen to your health care provider as a colposcopy may be needed.
Cervical Cancer cells
Squamous cell carcinoma or adenocarcinoma can be found on a Pap smear. It’s a rare case to happen for women who take regular intervals for screening. The health care staff will endorse follow-up procedures for you to take. Your past and recent Pap test results will be the basis of these procedures.
How Can You Prevent an Abnormal Pap Smear?
Here are some helpful tips for lowering your chances of getting cervical cancer.
- Get a vaccine: As getting cervical cancer is prevalent, get vaccinated to prevent HPV infection. Younger women must get vaccinated as early as they can. It also helps to avoid getting an infection and fight the possible viruses that target the human body.
- Practice safe sex: Always use protection for any sexual contact to avoid any sexually transmitted disease. Always use condoms to prevent HPV infection.
- Have regular annual check-ups: If you want to feel secure about your health, have an annual appointment with your doctor to avoid any potential gynecological headaches. Follow the recommended advice from the doctor as much as possible.
- Get tested: Make an appointment for a Pap smear as prescribed by the health professional. You can also consider getting an HPV test or Pap- HPV co-testing. Give the necessary information about your condition, such as your medical history, for a more accurate analysis of your health status.
What Is the Follow-Up Treatment for an Abnormal Pap Smear?
For the next step, the previous results are important factors to consider. The following information is needed for the health care provider to evaluate:
- Your age
- Cervical cancer screening results
- Previous treatments you took for cervical cancer
- Repeat the Pap contest over a span of 1-3 years
- Undergo a colposcopy
- Undergo a biopsy
- Take necessary treatments for severe changes of high-grade cervical cells
What Is a Colposcopy?
In this procedure, the health care staff will insert an apparatus called a speculum for the opening of the vagina to take a closer look at the cervix.
The health care staff now applies a vinegar solution on the cervix to identify the areas of abnormal changes.
Then, a medical tool called a colposcope is placed near the vagina as it has a magnifying lens for a better view of the cervix.
What Is a Biopsy?
After the colposcopy, the second procedure is a biopsy. The health care provider will do the endocervical curettage. In this process, a sample of abnormal cervical tissue will be detached from your cervix and will be checked for signs of ailment.
Make sure to know and ask your healthcare provider about the process of biopsy. It can be hurtful as some women experience bleeding after the biopsy. Some women experience spasms that feel like menstrual cramps.
A pathologist for cervical intraepithelial neoplasia (CIN) will check the samples of biopsy. CIN designates the visible abnormal cervical cells on the cervical surface after the biopsy.
There are three scales for CIN, which are based on the microscopic evaluation of the abnormal cells on the Pap smear and the cervical tissues affected.
- For CIN 1, the changes are mild or on its low grade. These changes don’t need to undergo immediate treatment. In a Pap test result, there are visible LSIL changes here.
- For CIN 2, the abnormal cervical cells are removed, so the changes are restrained. Sometimes, these changes disappear over time. But it must be treated within 2 years.
- For CIN 3 changes, treatment is a must unless you’re in the middle of pregnancy. Consult your doctor right away.
What Are the Treatments for Women with High-Grade Abnormal Cervical Cells?
If a woman happens to have a high-grade cervical cell change, there’s a high risk of cancer development.
Excisional treatment must take place for removing abnormal cervical cells.
- Cold knife conization: For the removal of a cone-shaped part of the abnormal tissues, the doctor uses a scalpel. Medical anesthesia is given to the patient, and this can only be done inside the hospital.
- Loop electrosurgical excision procedure (LEEP): LEEP uses a thin wire coil where electric waves pass for the removal of the abnormal tissue. The doctor uses local anesthesia for numbing the part during the operation. It can be done in the doctor’s clinic as it only lasts for several minutes.
- Laser therapy: Using a light beam called a laser, the doctor destroys the abnormal tissue. Anesthesia is provided before the start of the treatment. It should be done in the hospital for safety precautions.
- Cryotherapy: By means of freezing, the abnormal cervical cells are destroyed by a particular cold probe. It also requires medical anesthesia, but it can be done in your health care provider’s clinic.
When to Stop Getting Pap Smears
The doctor may decide for a woman to stop getting Pap smear in the following situations:
Getting a Total Hysterectomy
Once a woman undergoes a total hysterectomy or the surgical process or removing the uterus with the cervix, taking a Pap smear can be paused. If the procedure is done for a noncancerous case like uterine fibroids, you can stop getting regular Pap smears. However, if the reason for getting a hysterectomy is due to a precancerous or cancerous case in the cervix, the doctor may suggest continuing to have a Pap smear.
At the age of 65, the doctor tells their female patients to stop getting Pap smears if the recent tests are negative for cervical cancer.
Make sure to properly discuss with your doctor to conclude the best decision about what’s best for your health as the risk factors may develop. And if you have multiple sexual partners, better to continue having a Pap test.
All American Hospice Care is Here For You
If you or anyone you know is experiencing abnormal cervical cell changes, you can seek help from All American Hospice Care. With a group of medical professionals willing and ready to serve you in your medical conditions, we promise to give you our utmost attention for everything you need.
For more information regarding an abnormal Pap smear and its treatment, take time to visit our website. Learn the effects of having this result and know the necessary precautions to prevent cervical cancer. Contact us today for your first consultation and let yourself know more about us.