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Preventative Health Guide

Abnormal Pap Smears and Colposcopy

HPV Vaccine

Mammograms

Preparing for Surgery

Urinary Incontinence

Pelvic Prolapse

Osteoporosis

Gyn FAQs

Abnormal Pap Smear & Colonoscopy

The pap smear is a screening test for cervical cancer. It collects cells from the cervix which are then reviewed by a pathologist for evidence of abnormal cells. The pap smear is an ideal screening test because cervical cancer usually takes several years to develop so regular pap smears allow us to diagnose the pre-cancerous changes so that we can intervene before they develop into cancer.

The results of your pap smear will be reported in several different categories:

  • Negative (normal)
  • Atypical squamous cells of undetermined significance (ASC-US)
  • Atypical squamous cells suspicious for high grade intraepithelial lesion (ASC-H),
  • Low grade intraepithelial lesions (LSIL). The LSIL category includes changes consistent with HPV, mild dysplasia, or CIN I (grade 1 cervical intraepithelial neoplasia).
  • High grade intraepithelial lesions (HSIL). HSIL includes changes consistent with moderate or severe dysplasia, CIN II or III, and carcinoma in situ (CIS).
  • Carcinoma
  • Atypical glandular cells (AGC) may be endocervical, endometrial, or other glandular cells
  • Endocervical adenocarcinoma in situ (AIS)
  • Adenocarcinoma


    • What causes abnormal paps?

    The majority of abnormal paps are caused by an infection with a virus known as the human papillomavirus (HPV). HPV is the most common sexually transmitted disease. The majority of people do not have any symptoms of the infection and will clear the infection on their own.

    There are over 100 strains of HPV and over 30 of them are involved with genital infections. The different strains are categorized into "low risk" and "high risk" groups. High risk strains cause abnormal paps and can lead to cancer of the cervix, vagina, vulva, anus or penis. Low risk strains can cause mildly abnormal changes in pap smears and also cause genital warts.



    How do we manage abnormal paps?

    If you have an abnormal result on your pap smear, your doctor will may recommend you undergo colposcopy. Colposcopy is a procedure done in the office during which your doctor will look carefully at your cervix with a colposcope (a kind of microscope for the cervix). If any abnormal cells are seen, biopsies will be taken. The procedure takes 15-20 minutes and does not require any anesthesia. You may want to take 600-800 mg of ibuprofen before the procedure to help with cramping.

    If the biopsy is abnormal, the management may include simply repeating your pap in 4-6 months, cryotherapy (freezing of the abnormal cells on the cervix) or removal of the affected part of the cervix (a procedure called a LEEP or a cone). Your doctor will tell you what is the best choice for you after the biopsy results come back.

    You can also make some lifestyle changes that will help your body to clear the infection on its own. If you are currently a smoker, quitting may be enough to return your pap smear to normal.

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