What an Abnormal Smear Test Results?

In the US, women are offered regular Pap smear tests, as well as other services to prevent diseases such as cervical cancer from developing.

In 2007 alone, about 318,220 women were screened for cervical cancer through a Pap smear test and found 4,996 cervical cancers and high-grade precancerous lesions.

Hearing such things as "cervical cancers" and "high-grade precancerous lesions" must be very scary for women. It can also be scary (and at the same time very confusing) to hear that your Pap smear tests is not "normal".

What does an abnormal Pap smear test mean?

Unlike finding out that you have cervical cancer or precancerous lesions, most of the time; an abnormal a Pap smear means you will have to repeat your Pap test sooner that normal. Or that your smear test result requires further investigation at the hospital.

An abnormal smear though, does not mean that you have cervical cancer, or that you’ll develop it in the future. And with programs such as the NBCCEDP in place, women, including natives, low-income and uninsured, are provided services to prevent or lower their risks of developing cervical cancer. In fact, these programs are so successful that, as of 1997, cervical cancer death rate is down to 2 deaths per 100,000 women.

Also, the proportion of women who have ever received a Pap smear test has increased to 97 percent, while the proportion of women who have received a Pap smear test in the last 3 years increased to 90 percent. (Source: CDC)

Over the years, cervical cancer has become extremely rare in women who have regular Pap smears.

Why you should have regular smear tests

Next to breast cancer, cervical cancer is the most common cancer to develop in women. It accounts for 15 percent of all cancers in women. Before that actual cancer develops, changes in the cervix which healthcare providers identify as early warning signs can be detected by smear tests. Early detection and treatment stops the cancer from developing. The number of cervical cases has since been down to one half.

Pap smears are offered to women aged 20-65, as well as women over 65 who previously had abnormal smear results.

Normal smear

Normally, Pap smear tests get a sample of cells from an area of the cervix where the soft lining of the inner cervix meets the tougher lining of the outer cervix. This is known as the transformation zone. This is where the changes which may lead to cancer happen. Once your healthcare provider has taken a sample, he or she will wipe the brush onto a glass slide which will be read by the pathologist.

Unsatisfactory smear

This means that the pathologist is not satisfied or certain that what he or she has is a good sample from the cervix. It could be because there is too much blood or mucous present, contamination by a foreign object or inflammatory cells which indicates a reaction of the body to infection or trauma.

The pathologist may also feel that there was not enough of the transformation zone sampled to be able to get a conclusive or reassuring result. Whichever the reason, a cancerous or precancerous finding is unlikely.

If you receive an unsatisfactory smear, the pathologist may refer you to the hospital to find out the cause.

Only about 1-2 percent of women aged 25-35 will have abnormal smears.

Abnormal smear and cancer risks

The degree of abnormality of the sample reported by the pathologist is important to determine whether it could develop into cancer later on. Abnormal smears are graded as mildly, moderately or severely abnormal. Mildly abnormal smears are not likely to pose harmful short-term risks and underlying changes will likely regress to normal.

It is difficult to determine the percentage of untreated abnormal smears that will develop into cancer since abnormal smears are being treated. Also, during the sampling process which looks at what’s present, may stop the development.

About 30-60 percent of untreated moderate to severely abnormal cells develop into cancer in about 10 years. Over the course of this period, approximately one-third of the cancers, if left untreated, might become invasive with the potential to be harmful or fatal.

HPV and its effect on your smear

About 2 percent of women will have evidence of the human papillomavirus on their smears, even if they do not have genital warts. Some HPV variants are known to cause precancer. However, only about 15 percent of women with HPV on their smear are at risk of developing precancer. As with other mild changes, it may be that the HPV changes may stop without anymore action. Most doctors would suggest further investigation at the hospital it is shows up in two smears.

Further investigation and treatment

Further investigation means you will be checked by a gynecologist, pathologist or genitourinary medicine physician who is specializes in diagnosing and treating cervical abnormalities. This procedure is called colposcopy. During a colposcopy, the doctor passes a speculum, and then uses a colposcope to check the cervix. The colposcope does not touch you, and the doctor looks into it at the end of a couch.

At this magnification, the doctor can see more easily the transformation zone and search for abnormal areas that could be causing the abnormal cells on your smear. If an area looks abnormal, a small sample is taken which lets the pathologist see where the abnormal cells came from. With his findings, the genitourinary medicine physician taking the colposcopy can properly treat the abnormal area.

Most treatments require local or no anesthetic and take only about 20-30 minutes at most. When the upper end of the abnormal area can not be seen a general anesthetic may be required for treatment

There are a few after-effects though. You will need to abstain from intercourse for 10 days or more.


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