A pap smear is a test done on the cervix. The test is named after Dr. Papanicolaou. He discovered that you can tell if there are changes on the cervix that are cancerous or pre-cancerous from looking at the cells on the surface. Since this initial discovery, others have discovered that the abnormalities are usually caused by the virus we call Human Papilloma Virus, or HPV for short. This virus has many subtypes. Some of them cause venereal warts (condyloma), some cause plantar warts and some cause common warts.
Many women become infected with the HPV virus when they become sexually active. By the age of 50, 80% of women have become infected. Every year about 6.2 million people get HPV. Most women have no symptoms. Some women have external warts. Others have changes on their pap tests. It can be passed to a partner without either knowing about it. Most men do not have visible lesions. There is a vaccine that can be given to girls ages 9-26 to prevent them from getting certain types of the virus. It has recently been approved for boys also.
When doing a pap smear, your doctor will take a sample of cells from the cervix and send it to the lab. The cells may be spread on a slide. Recently we have started putting them in a liquid solution. If they are in the solution, we can do a lot of other tests on the same swab, including: Chlamydia, gonorrhea, Trichomonas, gardnerella, and multiple other diseases. If you are concerned about STDs, you should discuss this with your doctor before you have the Pap test, so the appropriate swabs can be taken.
Depending on the lab, the results may take a few days to a couple of weeks to come back. Every doctor’s office is different. Before you leave the office, you need to ask how the results will be relayed to you. Some offices have a policy of “If you don’t hear from us, everything is fine”. Other offices ask you to call after a certain amount of time. Others will mail or call results. Make sure you know how you will be contacted and that you have left appropriate contact instructions.
What you are hoping to hear is: “Your pap was normal. We need to see you back on your routine schedule.” If you hear something else, don’t panic. This article will hopefully help explain some of those other results.
CIN is an abbreviation for Cervical Intraepithelial Neoplasia. This is the term we used before we started to use the term SIL or Squamous Intraepithelial Lesion. CIN has three grades. CIN1 is the mildest. It is a slightly outdated term, but some offices still use it.
Dysplasia is another term for precancerous cells. Dysplasia can be mild (CIN1), moderate (CIN2), or severe (CIN3). Again, this is an older term, but many offices still use it, since it has more grades than the current system.
ASCUS (Atypical Squamous Cells of Undetermined Significance) – there are changes in the cervical cells. They usually are related to HPV, but precancerous changes cannot be ruled out.
SIL (Squamous Intraepithelial Lesion) The current term for dysplasia or CIN. LSIL (Low grade SIL) is the same as mild dysplasia or CIN1. HSIL (High Grade SIL) encompasses CIN2, CIN3 and Carcinoma in Situ. Carcinoma in Situ (CIS) is the most severe form of HSIL and will most likely progress to cancer. In the dysplasia system, it would include moderate dysplasia, severe dysplasia and carcinoma in situ.
ASCUS-H (ASCUS cannot rule out High Grade Lesion) There are changes of the cervical cells. They are not clearly precancerous, but further testing is definitely indicated to rule it out.
AGC (Atypical Glandular Cells) – There are changes in the glandular cells at the inside of the cervix that may be precancerous.
Cancer – abnormal cells that look like they have spread into the cervix or beyond.
Remember that the Pap smear is only a screening test. These results must be confirmed by a biopsy. Also remember that these changes are very slow. You have time to get to the doctor’s office, get further testing and find out what exactly is happening to your body.
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