A pap test is a regular test done on women between 18 and 65 years of age to evaluate and screen for cervical cancer and other cervical problems. Pap tests involve the insertion of a speculum into the vagina to open the it. The doctor then scrapes a small number of cells from the cervix, which are evaluated under a microscope to identify abnormalities. An abnormal result can indicate an infection, irritation or the presence of precancerous cell changes or cervical cancer.
Pap Test Results
The Bethesda System is the standard system used within the United States to classify pap test results. The system is used to evaluate results and any potential abnormalities and make treatment decisions. Bethesda classifications include normal, atypical squamous cells (ASC or ASC-US), low grade squamous intraepithelial lesions (LSIL), high grade squamous intraepithelial lesions (HSIL), atypicl glandular cells or cancer. Women with a result of normal do not need further testing and can continue their regular pap smear schedule. Women who receive another diagnosis may need additional testing.
Atypical Squamous Cells
An ASC result on a pap smear indicates that there was something abnormal about the cells. The abnormality might indicate that precancerous cells are developing, but not necessarily. The abnormal cell changes may simply be indicative of an infection, irritation or recent intercourse. Some doctors will simply recommend that the woman repeat the pap test in four to six months. Other doctors administer a test for high-risk HPV strains. If a woman tests positive for a high-risk strain of HPV, it suggests that the changes might be precancerous, and a colposcopy is performed. This involves inserting a coloscope into the vagina so the doctor can look at the cervix to check for abnormalities.
Squamous Intraepithelial Lesion
There are two different types of SIL results that can be identified in the cells on a pap test. The first is LSIL--low-grade SIL. This may mean that mild precancerous cell changes exist that can clear up on their own. Often, the recommendation here is to repeat the pap test in four to six months. High-grade SIL, or HSIL, indicates that moderate to severe precancerous cell changes exist. A colposcopy is done to determine the extent of the abnormal cells or the abnormal cell count, and surgery including freezing (cyrosurgery) or laser surgery may be done to kill the abnormal cells. This usually does not have an effect on fertility.
Atypical Glandular Cells
The presence of atypical glandular cells indicates invasive squamous cell cancer. Further testing must be done to evaluate these cells. A colposcopy and a cervical biopsy are usually performed to determine the abnormal cell count and the extent of the presence of cancer cells in the cervix.
Cancer
Once cancer cells are detected in a pap smear, the woman is diagnosed with cervical cancer. The best method of action is referral to an oncologist, who can discuss cervical cancer treatments.
Tags: cell changes, cervical cancer, precancerous cell, precancerous cell changes, abnormal cell, abnormal cells
