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Abnormal Pap Smears

By Tracee Cornforth, About.com

Updated: July 01, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Pap Smear Facts

  • All women age 18 and older (younger, if sexually active) need to have regular Pap smear screenings.

  • The Pap Smear test is the only screening test for cancer, in the world, which has caused a decrease in occurrences and deaths from cancer.

  • A Pap Smear is a screening tool, not a diagnostic test; further evaluation is required when abnormal changes are detected.

  • A normal Pap Smear is not a guarantee of no cancer; it does not detect cancers of the uterus, fallopian tubes, or ovaries.

  • Your physician may advise you to continue having regular Pap smears even after a hysterectomy.

  • Your physician will determine when you should have your next Pap smear, though every 6- 12 months is usually recommended.

  • Pap Smears can be safely performed during pregnancy

A new pap test has been developed, the PapNet test. The cost is slightly higher than a normal Pap test; however, the benefit of catching pre- cancerous changes, several years earlier should outweigh any additional cost.

What causes abnormal Pap smears?

Abnormal Pap smear results are often explained by an infection or an inflammation. Yeast infections, herpes, trichomonas, recent sexual activity, or use of vaginal preparations, are often things which cause an abnormal Pap smear result.

Many times the culprit is HPV or human papilloma virus, sometimes referred to as genital warts. HPV is a common infection in women and has been detected in women in their seventies; up to 60% of sexually- active women may carry this virus on their cervix, genital area, or skin and are completely unaware of it.

How a pap smear looks...

When your Pap smear is sent to the lab it is viewed under a microscope, a normal Pap smear will appear as in this photo from the Mayo Clinic and an abnormal Pap smear will appear in a distorted manner as in this photo depicting cervical cancer, also from the Mayo Clinic.

Some words you may hear and possible diagnostic procedures...

Class 1
normal
No treatment required

Class 2
atypical (could be caused by inflammation or infection)
You're physician may recommend another Pap Smear or Colposcopy

Class 3
dysplasia or pre- cancerous, low grade
Colposcopy is required to diagnose cause; possible further treatment

Class 4
high grade dysplasia or CIC (carcinoma in- situ; cancer but, non- invasive)
Coloposcopy required with possible Cone biopsy or LEEP procedure

Class 5
Cancer, invasive
Coloposcopy to determine severity and further recommended treatment

Should you be worried?

Being alarmed or worried is a completely normal reaction when told your Pap smear is abnormal but, it's important to remember that most cases of abnormal Pap smear results do not indicate cancer.

What an abnormal Pap smear does mean is further diagnostic procedures must be discussed with your physician; abnormal Pap smear results will usually require re- testing in three to six months or Colposcopy.

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