What does an abnormal Pap smear mean?
A Pap smear, also known as a Pap test, is a screening test usually done alongside a pelvic exam. A Pap test looks for any abnormal or precancerous cell changes in the cells on the cervix — the canal between the vagina and uterus.
If the Pap test results show these cell changes, this is usually called cervical dysplasia.
Cervical dysplasia is a condition of abnormal cellular growth on the cervix.
Abnormal Pap test results do not mean you have cancer or will have cancer in the future. Most women with abnormal Pap smears never develop cancer, some may have very treatable pre-cancer.
Low-grade cell changes tend to go back to normal on their own. However, high-grade changes can develop into cancer if the cells aren’t removed.
What causes cervical dysplasia?
Dysplasia is usually caused by the human Papillomavirus (HPV). HPV is a common sexually transmitted virus that can be passed from person to person during vaginal, anal, and oral sex. Both women and men can be infected with HPV.
Because HPV is typically asymptomatic, many people may be infected with the virus without realizing it. In fact, most sexually active people will get it at least once in their lives, but won’t know because their immune systems clear it before it becomes a problem. However, in cases where the immune system can’t get rid of it, HPV will cause mild to severe dysplasia in the cervix.
Just because you have cervical dysplasia, it does not mean you will get cervical cancer. However, Dr. Aliabadi will want to closely monitor your cervix more frequently – and possibly conduct treatment – to prevent further cell changes that may become cancerous.
I have abnormal Pap smear results. Now what?
An abnormal Pap smear is a red flag that a patient has cervical dysplasia, and further evaluation is recommended to determine the appropriate diagnosis and treatment. Further testing includes cervical cancer screening tests such as:
- Colposcopy. First, vinegar or acetic acid is used to stain the cells of the cervix and vagina. The doctor then uses a colposcope to magnify the appearance of the cervix and see where the abnormal tissue is. Depending on the size and number of the abnormal cells, Dr. Aliabadi may take a tissue sample for further testing.
- HPV test. There are two strains of HPV that are specifically high risk for cervical cancer: HPV 16 and 18. A biopsy of the abnormal cells allows Dr. Aliabadi to test for these specific strains of HPV.
- Endocervical curettage. Using a spoon-shaped tool called a curette, our doctor scrapes the cervix to collect a thin layer of cervical cells.
- Cone biopsy. A cone biopsy removes a cone-shaped wedge of abnormal cells. It takes more tissue than a regular cervical biopsy, providing more test material.
Risk factors for cervical dysplasia
Most cervical dysplasia is caused by HPV, so anything that increases your risk of HPV exposure or weakens your immune system will increase your risk. Some things that increase your cervical dysplasia risk include:
- Weakened immune system. Any condition that suppresses or weakens the immune system increases the risk that an HPV infection will result in cervical dysplasia.
- Immunosuppression medication. Patients who’ve recently undergone an organ transplant or who have an autoimmune disease may be treated with immunosuppression medication which weakens the immune system.
- Smoking depresses antibodies and weakens the immune system. Smokers are two times more likely to develop a severe case of dysplasia than non-smokers.
- Unsafe sexual practices. Having multiple sexual partners or not using condoms increases your risk of HPV exposure.
The American Cancer Society recommends that women should begin regular cervical cancer screening at age 21.
A vaccine to prevent cervical dysplasia and cervical cancer
One important step in significantly reducing your chances of dysplasia and cervical cancer is to get the HPV vaccine. Two drugs have been approved by the FDA: Gardasil and Cervarix. They have been found to prevent the most dangerous strains of HPV, including the strains that are known to cause cervical cancer and genital warts.
The Centers for Disease Control advises that girls get vaccinated well before they are sexually active – at age 11 or 12. It is strongly recommended because it is currently the safest and most effective method to prevent cervical cancer. Girls and young women over the age of 12 should get vaccinated as well, even if they are already sexually active.
It is also recommended that men get vaccinated against HPV.
What is cervical dysplasia treatment?
Dr. Aliabadi will make sure you understand the many options available for treating dysplasia. Your treatment plan will depend on your age and the severity of your case. In mild cases, especially in older women, you may only need monitoring with repeat Pap smears every few months.
Possible treatments for dysplasia include:
- Cone biopsy can be used to both examine and remove the portion of abnormal cervical tissue growth.
- Loop electrosurgical excision procedure (LEEP) excises the portion of abnormal cervical cells using an electrified wire loop instrument.
- Laser surgery
- Electrocauterization
- Cryosurgery
Each of these treatments carries a risk of bleeding and may increase the risk of complications during pregnancy. Women who plan on carrying children in the future should talk to their doctor about their concerns.
After treatment, our gynecologist will likely recommend follow-up Pap smears every few months to make sure all of the abnormal cells have been removed. After a few consecutive normal tests, you may return to an annual regular Pap smear schedule.
Hysterectomy is often used in cases where the area of abnormal growth was found in the glandular tissue of the cervix or if severely abnormal cells were not completely removed by other treatments. With a total hysterectomy — removal of the uterus and cervix — you will no longer be at risk of cervical cancer.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When you’re treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Abnormal Pap test FAQs
Can there be a false abnormal Pap smear?
It is possible to have a false abnormal if vaginal cream, gels, medicines, or douches have been used within 48 hours of a screening test, or if you had sex, or are menstruating. Yeast infections can also affect the results of a Pap test, sometimes causing a false or unclear result.
What are LSIL and HSIL?
LSIL (Low-grade Squamous Intraepithelial Lesion) and HSIL (High-grade Squamous Intraepithelial Lesion) are terms used to describe abnormal changes in the cells on the surface of the cervix.
LSIL indicates mild abnormalities, often associated with human Papillomavirus (HPV) infection. These low-grade changes are usually not immediately dangerous and might resolve on their own without treatment, though they do require monitoring to ensure they do not progress.
HSIL, on the other hand, suggests more significant abnormalities that are more likely to lead to cervical cancer if left untreated. HSIL is considered serious and usually requires further diagnostic testing.
What are other causes of an abnormal Pap test?
While atypical squamous cells of undetermined significance (ASC-US) are the most common abnormal Pap test findings, this result just means some cells don’t look completely normal. It’s not clear if the changes are caused by HPV infection.
A sexually transmitted infection, such as herpes or trichomoniasis, inflammation in the pelvic area, or changes in hormones that occur during pregnancy or menopause can also cause cells to look abnormal.
Other common terms used to describe abnormal Pap results include:
- Abnormal cell changes
- Precancerous cells changes
- CIN (cervical intraepithelial neoplasia)
- SIL (squamous intraepithelial lesions) low to high-grade
All of these terms mean the same thing — abnormalities were found.
How is a Pap test performed?
How is a Pap test performed?
The patient lies on an exam table and a speculum is inserted into the vagina to widen it, allowing your OB-GYN to access and view the cervix. Using a small brush or spatula, the provider gently scrapes a sample of cells from the cervix. This sample is then sent to a laboratory for analysis to check for abnormalities that could indicate conditions like cervical cancer or precancerous changes.
Sources
Pap test. Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/Pap-test. Accessed May 28, 2018.
Cervical Cancer Screening – National Cancer Institute https://www.cancer.gov/types/cervical/screening
If you are suffering Cervical Dysplasia or have had an abnormal PAP smear, please discuss this with your doctor immediately. And as always, if you have any unanswered questions about your health, talk to your doctor.
We also invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863- 6700.
