Pap smear (also called Pap test) is a screening test performed to evaluate the health of your cervix and to help in detecting early signs of cervical cancer by identifying presence of cancerous or precancerous cells in the cervix.
What is cervical cancer? Cervical cancer is one of the most common causes of cancer-related mortality in women. One of the major causes of cervical cancer is viral infection by human papillomavirus (HPV) type 16 and 18.
What are the Risk Factors Of Developing Cervical Cancer or HPV Infection?
Women who are active smokers, have had many sexual partners, were sexually active from an early age, have a weak immune system (either due to chemotherapy or organ transplant), have a prior history of lower genital tract cancers, or are HIV positive are at a greater risk for developing cervical cancer and are more susceptible to the HPV infection.
What Can You Tell From A Pap Smear Result?
This test is usually done as part of your annual check-up with your gynecologist, but it can be done at a separate visit as well. It typically takes a week or two to get back the results from the Pap smear. Pap smear results are classified as either normal or abnormal. Sometimes the test may also be inconclusive in which case you may need to repeat the test.
Normal results are also sometimes referred to as a negative Pap smear. This means that no abnormal cells were detected in your cervix and you do not need another Pap smear for the next three years.
Abnormal results are also at times referred to as a positive Pap smear. Abnormal Pap smear results simply indicate that there was presence of abnormal cells (cells of different size and shape) in your cervix. These could be precancerous in nature, but we cannot say for certain if they confirm the presence of cancer.
What Does It Mean When You Have An Abnormal Pap Smear?
If your Pap smear exam result was abnormal then it confirms the presence of abnormal cells in your cervix. As per the National Cancer Institute, abnormal cells can be classified according to the type of cell and the grade of abnormality seen. Atypical glandular cells (AGC) are the cells that produce the mucus in the cervix and changes in these cells do not indicate a serious condition, but do need further investigation.
Atypical squamous cells (ACS) are the cells that form the main surface of the cervix and can either be of undetermined significance (ACS-U) or high risk of being precancerous (ACS-H). Endocervical adenocarcinoma insitu (AIS) indicates the presence of precancerous cells in the glandular tissue. Low-grade squamous intraepithelial lesion (LSIL) indicates that the cells that form the surface of the cervix have a lesion and this could be because of HPV infection. High-grade squamous intraepithelial lesion (HSIL) indicates the presence of precancerous cells that have a high probability of developing into cervical cancer.
Certain conditions are likely to cause a false positive or a false negative. If you engaged in sexual intercourse or if you used feminine hygiene products (such as tampons, douches, spermicidal creams etc) a couple of days before your appointment, it is likely to interfere with your results. In addition, if you have an existing cervical infection (yeast, trichomonas, chlamydia, or gonorrhea) than it will cause the cells in the cervix to appear inflamed and abnormal. This may mean a simple infection with nothing serious or this infection could hide a potentially more serious condition such as cervical cancer. In such cases, it is necessary to treat the infection first and then repeat the test in another couple of months.
If your Pap smear test was abnormal, than depending on the nature of the abnormality, the doctor will recommend you to either repeat the test or increase the follow-up frequency. The doctor may even recommend further investigation by ordering a colposcopy or cone biopsy.