What Does an Abnormal Pap Smear Mean? What You Should Know About Irregular Ovarian Cells

Pap smears, also known as a pap screening, pap test and cervical cytology, have been one of the most successful preventative care measures undertaken in medical history, having proven to reduce cervical cancer rates by almost 80 percent. A pap smear is a minor procedure where cells are collected from the cervix. A health care provider inserts an instrument called a speculum into your vagina, which spreads the vaginal wall to show your cervix. Then, a small brush, swab, or spatula is used to gently remove cells from the cervix and back of the vagina. These cells are then tested for signs of cervical cancer and infection, which, if found early, are more likely to be cured. Pap smears are also able to detect precancerous cells, allowing for treatments to prevent cancer in the future. 

Are Pap Smears and HPV Tests the same? 

No. The procedure is exactly the same but not all pap smears include screening for human papillomavirus (HPV), which is a common virus passed through sexual contact, and can lead to cervical cancer. HPV tests look for HPV in the cervical cells whereas Pap Tests look for cancers and precancers in the cervix. If you would like to be tested for both cervical cancer and HPV, make that known to your healthcare provider and the tests can be combined. 

What types of results can I receive from a pap smear? 

Usually, there are three categories of results you will receive from a pap smear. 

Normal: 

This means no abnormal cervical cells were found. A normal test result can also be called a negative test result or negative for an intraepithelial lesion, which essentially means there are no areas of abnormal cell growth. 

Unsatisfactory: 

This result means that the lab may not have had enough cells that may have been clumped together or hidden by blood or mucus. This is why healthcare providers recommend not getting a pap smear when you are menstruating or have just had intercourse. If your results come back unsatisfactory, your healthcare provider will ask you to come in for another pap test in 2 to 4 months. 

Abnormal: 

This result is sometimes called a positive test result. This means that some of the cells of the cervix look different from the normal cells. 

What does it mean when my Pap Smear is Abnormal? 

Hearing that your pap smear results are abnormal, can be very alarming. Immediately, you think the worst. However, abnormal pap smear results can appear for a variety of reasons, many of which aren’t directly related to cancerous or even pre-cancerous cells. 3.8 percent of pap tests come back abnormal, according to the National Institutes of Health. 

An abnormal pap smear means that the cells taken from your cervix look different under the microscope than normal cells. These are the types of cells that will be considered abnormal in a pap smear. 

Atypical Squamous Cells of Undetermined Significance (ASC-US): 

These are the most common cells in an abnormal pap test. These cells don’t look completely normal, but it is unclear if these cells are changed due to an infection. Things that can cause ASC-US are yeast infections, growths, HPV, and changes in hormones that occur during pregnancy or menopause. These abnormal cells are not related to cancer. Your healthcare provider will usually do an HPV test to see if the cell changes are caused by HPV. If that test is negative, an estrogen cream may be prescribed to see if the abnormal cells were caused by low hormone levels.

Atypical glandular cells (AGC): 

These are cells that are a sign of a more serious problem up inside your uterus. These results will likely result in your coming back for a colposcopy. 

Low-grade squamous intraepithelial lesions (LSIL): 

These are low-grade cell changes that are usually caused by an HPV infection. You will most likely be asked to come back for some additional testing to make sure that they are not more serious, high-grade changes. 

High-grade squamous intraepithelial lesions (HSIL): 

These are moderately or severely abnormal cervical cells that could become cancerous in the future if not treated. These results usually will be followed up by a colposcopy. 

Cervical Cancer cells (squamous cell carcinoma or adenocarcinoma): 

This result means that the abnormal cells are cancerous. These results will be followed up in certain tests to see if the cancer cells have spread. These results are very rare for people who are having regular pap screenings. 

What is a colposcopy? 

A colposcopy is a 10-20 minute exam to closely look at the cervix. A special magnifying instrument, called a colposcope, is used to do this. The procedure is similar to a pap smear or pelvic exam, where a speculum is placed in your vagina. The colposcope is then placed a few inches away from your vulva, a bright light is shined into your vagina, and your healthcare professional looks through the lens of the colposcope, as if using binoculars. 

If there are any suspicious areas, a small sample of the tissue may be taken for lab testing. To collect a sample, a sharp biopsy instrument is used to remove a small piece of tissue.

Having regular pap smears is vital to being informed about your cervical health. It is recommended that people with uteruses between the ages of 21 to 29 should have a Pap test every 3 years. People with uteruses from 30-65 are recommended to have a combined Pap Test and HPV test, every 5 years.