Abnormal Pap Smears
One in 10 Pap smears will have some abnormality, so don't panic if you get
a call from your doctor's office asking you to return. Don't panic, but do
go! Most of the time abnormal results are due to collection errors, changes
associated with inflammation, or a precancerous lesion. The good news is that
most cervical abnormalities detected by Pap smears are treatable.
There are basically four stages of cervical disease as reported by the Pap
- Healthy - although inflammation or infection may be present, no atypical
cervical cells are noted. If you have inflammation or infection, your doctor
may recommend treatment and repeating the Pap smear in 3-6 months.
- Low-grade disease - which can include "ASCUS", meaning
"atypical squamous cells of undetermined significance". If a Pap
smear shows questionable or low-grade changes, your doctor may recommend repeating
your Pap smear in three to six months. But if you've had a previous abnormal
Pap or a known sexually transmitted disease (STD), s/he may recommend further
testing, including a test for human papilloma virus (HPV) that can be done
in conjunction with the Pap smear as well as an in-office examination with
a special magnifier called a colposcope. With the colposcope and a special
dye, your doctor can perform one or more small cervical biopsies of the abnormal
areas identified. This permits an accurate diagnosis and helps determine the
extent of any pre-cancerous changes.
- Hi-grade disease - severe dysplasia, or "carcinoma in situ",
where abnormal cells are limited to the surface of the cervix. In this case,
conservative treatment is usually effective.
- Invasive cancer - where cellular abnormalities are found deep in
the tissue of the cervix. In this case, hysterectomy is usually required.
The good news is that cervical cancer is preventable, diagnosable, treatable
and curable if detected in its earliest stages. Cervical cancer is also generally
a very slow growing cancer. When cervical cancer is detected at an early stage,
the five-year survival rate is 92%. For those patients whose cervical cancers
are not detected early, compelling clinical studies support a treatment strategy
anticipated to cut the death rate in half by adding chemotherapy to radiation
after hysterectomy. The increasing use of routine Pap smear testing with
the newest technologies should continue to improve outcomes for women.
Created: 2/21/2005  - Donnica Moore, M.D.