Abnormal Pap Smears
A Pap smear is a screening mechanism only, not a diagnostic test. An "abnormal" or "positive" Pap smear does not mean that you have cervical cancer. It simply indicates that unusual cells have been detected on the cervix and that additional diagnostic testing may be required.
These unusual cells can include any of the following.
Atypical Squamous Cells of Undetermined Significance (ASCUS)
ASC-US is the most common abnormal PAP testing finding. It does not mean you have cervical cancer, this means some of your cervical cells were slightly abnormal. Most of the time these changes are caused by irritation, infection, or hormonal changes.
Atypical Squamous Cells (ASC-H)
ASC-H does not mean that you have cervical cancer. The words "atypical squamous cells" mean that some of your cervical cells looked abnormal. "Cannot exclude high-grade squamous intraepithelial Lesion" means the doctor who viewed your cells was not able to rule out precancerous changes in your cervical cells. Often, cell changes seen in ASC-H are caused by infection with Human Papillomavirus (HPV). Some types of HPV are called high risk because they can cause changes in cervical cells that, over time, could lead to cancer. A long-lasting (persistent) genital infection with high-risk type of HPV is the main cause of cervical cancer.
Human Papillomavirus (HPV) Positive, High Risk
High risk types of HPV can cause normal cervical cells to turn abnormal. Over time, those abnormal could turn into cancer. Long-lasting (persistent) genital infection with a high-risk type of HPV is the main cause of cervical cancer and a cause of other, less common cancers. Keep in mind that even though abnormal cells have been found, most women will never develop precancerous changes or cancer. Quite often, when healthy woman younger than 30 gets a genital HPV infection, her body will destroy the virus, her cervical cells will return to normal and she will not have any long-lasting health problems.
Low-Grade Squamous Intraepithelial Lesion (LGSIL)
This result does not mean you have cervical cancer, but your cancer risk may be increased. Often, cell changes seen in LSIL are caused by infection of the genitals with HPV, a common virus that is spread by skin-to-skin contact, including sexual contact.
High-Grade Squamous Intraepithelial Lesion (HGSIL)
This result means your risk of developing cervical cancer is high. In some cases, women with HSIL are found to have an early state of cancer called adenocarcinoma in situ. In situ means in place, so the cancer is only growing on the surface of the cervix. About 2% of women with HSIL are found to have invasive cancer- disease that has spread to tissue beneath the surface of the cervix. Immediate follow up will be needed
Atypical Glandular Cells
Glandular cells are found in the opening of the cervix and in the uterus. Should atypical cells be detected by the Pap smear, your physician will most likely schedule additional testing to determine the significance of the abnormalities.
Squamous Cell Cancer or Adenocarcinoma Cells
The discovery of either of these two forms of precancerous cells will require immediate follow-up diagnostic testing, evaluation, and treatment for the earliest phases of cervical cancer.
Follow-Up Testing and Treatment after an Abnormal Pap Smear
Any abnormal Pap smear will generally require additional follow-up testing, either to rule out the presence of precancerous cells or to conduct a more definite diagnostic test for cervical cancer. The appropriate test(s) to perform will depend upon previous Pap smear results, the specific findings of your most recent Pap smear, and any other risk factors such as the presence of HPV. Test results are typically reported in about two weeks.
Follow-up testing may include one or more of these routine procedures.