What an abnormal Pap Smear means

An abnormal Pap Smear can be earth shattering but it doesn’t always mean you have cervical cancer, writes DR MARGA BOYANI

A normal Pap smear means that no abnormal cells were detected. Schedule your next pap smear for a year later.

But while a positive result means that abnormal cells were found, this does not automatically mean you have cervical cancer.

An abnormal Pap smear may be:

Inflammatory

The inflammation is usually caused by infection, usually an overgrowth of the yeast or bacteria that live in the vagina. The Pap Smear needs to be repeated after six to eight weeks after the infection is treated because inflammatory cells may obscure abnormal cells.

Atypical squamous cells of undetermined significance (Ascus)

The Pap Smear showed slightly abnormal cells but it’s impossible to tell exactly what’s causing them. It could be anything including things that have nothing to do with cancer. However, the abnormal cells may also be pre-cancerous. You would need to repeat the Pap Smear every six months until you get three consecutive normal smears. Also, the doctor may suggest another test to determine the cause of the abnormal cells.

Atypical glandular cells of undetermined significance (Agus)

The Pap Smear showed slightly abnormal cells of the cervical glands and this needs more investigating than Ascus. You would need to have a colposcopy and a tissue sample taken because these cells have a higher chance of being abnormal.

Cervical intraepithelial lesion

Depending on the grading of this, the cells seen on the Pap Smear are consistent with pre-cancerous abnormalities. If it’s low-grade, the pre-cancerous cells present are years away from becoming a cancer or may never develop into cancer. If it’s high-grade, the pre-cancerous cells are further down the road to cancer and this has to be confirmed with another diagnostic test called a colposcopy.

How reliable is the Pap Smear?

The test is 98 per cent accurate. You could receive a false positive result, which means you don’t have abnormal cells in reality. You could also receive a false negative result, which means that the Pap Smear indicates there are no abnormal cells even though there are.

A false negative result doesn’t mean that a mistake was made, however. Many factors can cause it, including:

• The cervical swab catching only an area of normal cells on a cervix that has abnormal cells.

• A poor collection of cells.

• An inaccessible location of the abnormal cells.

• Blood or inflammatory cells obscuring the abnormal cells.

Although abnormal cells can go undetected, time is on your side because cervical cancer takes many years to develop. If one Pap Smear doesn't detect the abnormal cells, the next test most likely will.

Will I need to have my uterus removed?

A Pap Smear picks up early cancerous changes in the cells that are easily treatable without resorting to drastic measures. A second examination called a colposcopy is done if your pap smear shows abnormal cells and this provides a definitive diagnosis in contrast to the Pap Smear, which is a screening test.

What if it really is cancer?

Even cervical cancer caught in the early stages is treatable through surgery. The outcome is usually a good one with a survival rate of almost 100 per cent, but this all depends on the stage of the disease.

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