Pap tests seek out cells that could become cancer — don’t panic over an abnormal result
You know the routine: undress, change into a medical gown, wait for your OB-GYN, then rest your feet in the stirrups. But despite the familiarity of a Pap smear (also known as a Pap test), you might still wonder what they actually test for.
Jennifer Hill, a certified nurse practitioner with Kettering Health, explained that Pap smears screen for precancerous cells in the cervix, known as cervical dysplasia. In other words, the exam doesn’t look for cancer, but any cells with the potential to become cancer.
“People hear the word ‘cancer’ in precancerous and get concerned. But there are several levels of abnormality before we get to cancer,” she said. “If they follow up as recommended, we’re going to prevent it from ever turning to cancer.”
If you receive an abnormal result, don’t panic.
All an abnormal result means is there are changes in your cervical cells, either low or high grade.
Low-grade changes
A low-grade result suggests minor changes in your cervical cells. Not all lowgrade results are considered precancerous.
The result Hill sees most often is atypical squamous cells of undetermined significance (ASC-US). This means the cells are slightly abnormal. “The cells are not precancerous, but they are not typical,” she said. This may be from human papillomavirus (HPV) or inflammation caused by an infection.
Low-grade squamous intraepithelial lesions mean there is a mild yet clear abnormality in the cells, usually caused by HPV. Unlike AS-CUS, an LSIL result is considered precancerous. Most HPV cases and low-grade abnormalities resolve on their own. “The recommendation is just to repeat the Pap smear after a year,” Hill said.
High-grade changes
Some Pap smear results show a high-grade, or major, change in the cervical cells which have a higher risk of becoming cancerous if left untreated.
High-grade squamous intraepithelial lesions indicate a significant abnormality of the cervical cells, also usually caused by HPV. Hill explained that along with routine Pap smears, the best way to prevent cervical cancer is by getting the HPV vaccine.
The cervix has two types of cells: squamous cells, which form the outermost layers, and glandular cells, which form the innermost layers. Most abnormal Pap smear results indicate a change in the squamous cells, but atypical glandular cells reveal a change in those innermost cells. According to Hill, this could indicate advanced dysplasia or a more serious problem in the cervix or uterus.
Knowledge is health
Thinking about getting an abnormal result can be scary. But, Hill said, “It’s important to get regular screenings so we can identify a problem before it turns to cervical cancer.”
Schedule your Pap smear at ketteringhealth.org/gynecology/.