What does an abnormal Pap smear mean?
A Pap smear allows your doctor to look at the cells from your cervix (the lower part of your womb) and see if there are any problems, such as cancer. An abnormal Pap smear means that the cells of your cervix have shown some slightly abnormal changes. Some abnormal cells are more likely than others to be cancerous. If your Pap smear is abnormal, ask your doctor which of the following changes you have.
ASC stands for atypical squamous cells. Squamous cells form the surface of your cervix. ASC is divided into two categories:
- ASC-US means ASC with "uncertain significance": Although some of your cells are not normal, your doctor may not know why the cells changed or what impact it will have on you. These changes are usually not serious and may be caused by a vaginal infection or infection with a virus called HPV (human papillomavirus). Your doctor may want to do a follow-up examination such as a repeat Pap smear or HPV testing.
- ASC-H means ASC with possible HSIL: Some of your cells are not normal and there is a small possibility that they may be precancerous. Your doctor will probably want to perform a colposcopy, which will allow your doctor to more closely examine your cervix. (See below for more information on colposcopy.)
AGC stands for atypical glandular cells. Glandular cells are cells that produce mucus and are located in your cervix or uterus. These results mean that some of your glandular cells are not normal, but your doctor does not know why. These changes are usually more serious. People who have AGC can have a higher risk for cervical cancer. Your doctor will probably want to perform a colposcopy to examine any irregular tissue.
LSIL stands for low-grade squamous intraepithelial lesion. Low-grade means there are early changes in the size and shape of the cells. LSILs are often associated with the presence of HPV, which may also cause genital warts. You can be infected with HPV even if you or your partner have never had visible warts. Your doctor will probably perform a colposcopy, HPV testing or recommend a repeat Pap smear.
HSIL stands for high-grade squamous intraepithelial lesion. High-grade means the cells are very different from normal cells. These cells are usually precancerous and are more likely to lead to cervical cancer. Your doctor will probably perform a colposcopy to determine how at risk you are for cancer.
Squamous Cancer Cells
If the cells on the Pap smear appear extremely abnormal, it is likely you have cancer cells in your vagina, cervix or uterus. Your doctor will perform additional testing and then will talk to you about possible treatment options.
If inflammation is present in the cells on the Pap smear, it means that some white blood cells were seen on your Pap smear. Inflammation of the cervix is very common and usually does not mean there is a problem. If the Pap smear showed the inflammation is severe, your doctor may want to find the cause, such as an infection. Your doctor may also recommend a repeat Pap smear to see if the inflammation has improved or cleared up completely.
Hyperkeratosis is a finding of dried skin cells on your Pap smear. This change in the cells of the cervix often occurs from using a cervical cap or diaphragm or from having a cervical infection. Hyperkeratosis rarely needs any more evaluation than a repeat Pap smear in 6 months to 1 year. If the hyperkeratosis is still present on the repeat Pap smear, your doctor may want to perform another Pap smear or perform a colposcopy.
Written by familydoctor.org editorial staff