understanding your pap smear

 Papanicolaou (Pap)Test

The pap test is a screening tool that helps detect changes in the cervix. Regular pap smear's can help detect these changes early so they can be treated before becoming serious. The provider will use a small brush and/or a spatula to obtain the sample, and send it off to pathology. A pap test is quick and painless, though some patients don't find it very comfortable. The cells are examined by pathology and send our office the results. We will call you with your results. If the results are abnormal you may require further evaluation by colposcopy with possible biopsy. See below for further information regarding possible test results and treatment. 

ASCUS (Atypical squamous cells of undetermined significance): Slightly abnormal cells found on the cervix. Depending on the presence and type of HPV these cells could be benign. If HPV is negative these cells could indicate your menses starting or ending recently, recent intercourse, presence of a low grade vaginal infection, cervical irritation. If HPV is not present, we will simply repeat your pap in 1 year to ensure no further changes are occurring. If HPV is present this indicates it is causing very minimal changes in the cervix. Also, when HPV is present, the pathologists have been advised to see if the particular "types" of HPV we're specifically worried about are present. See below for further information regarding typing. Depending on your age and risk level we may repeat your pap, or you may need a colposcopy. 

AGUS (Atypical glandular cells of undetermined significance): This describes cells that are found on the glands in the walls of the cervix. These cells are rare. However, they can be a sign of a more serious lesion. Please make sure to make and keep follow up if you have been informed of having this type of pap result. 

HPV (Human Papilloma Virus):  HPV is sexually transmitted virus. There are 2 different types of HPV; low risk and high risk.  Low risk HPV causes genital warts.  High risk HPV is linked to cervical changes and cancer.  Abnormal pap smears are routinely screened for HPV.  You may have had the Gardasil vaccine, if not and you are interested in it, please let us know. 

"Typing": There are SEVERAL types of strains of HPV. Some of them are low risk and some are high risk. There are 2 specific types of high risk HPV that we are concerned about when screening your pap smear, 16 and 18/45. If you are positive for HPV and positive for one or both of those types it may be recommended you have a colposcopy. 

LGSIL (Low Grade squamous intraepithelial lesion): LGSIL is considered mild abnormalities usually caused by an HPV infection. What this tells us is that HPV is present, and causing changes in the cervix, however, those changes are minimal. 

ASC-H (Atypical Squamous Cells - Cannot exclude High Grade): Borderline results between types of HPV, but may really include High-Grade lesions.

HGSIL (High Grad squamous intraepithelial lesion): HGSIL is considered more severe abnormalities and have a greater chance of progressing to invasive cancer. The diagnosis of  HGSIL means the presence of precancerous cells, not cancer. And the precancerous cells may be mild, moderate, or severe. The designation of HGSIL refers to the presence of moderate or severe pre-cancer.

Colposcopy:  A closer look of the cervix, vulva, or vagina using magnification with a special instrument. Acetic acid is placed on the cervix or within the vagina. If cellular changes occur with the acetic acid the provider will perform a biopsy of the cervix and send that to pathology. In most cases the provider will take a biopsy to ensure there is no cause for concern. 

Dysplasia of the Cervix: Cervical dysplasia is a precancerous condition in which abnormal cell growth occurs on the surface lining of the cervix. There are 3 stages to dysplasia, mild, moderate, and severe. 

CIN (Cervical Intraepithelial Neoplasia): This is also used to grade cervical dysplasia. Typically labeled once a biopsy comes back from pathology. 

LEEP (Loop Electro surgical Excision Procedure): It is a way to test and treat abnormal cell growth on the surface tissue of the cervix. LEEP may be recommended after abnormal changes in the cervix are confirmed by Pap tests and colposcopy biopsies.

Cancer:  Severely abnormal cells or cancer in situ.