Abnormal Pap Tests

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What does an abnormal Pap result mean?

An abnormal Pap test does not mean you have cervical cancer. Approximately four million Pap tests are done every year in Canada. About 8% (over 325,000) have abnormal results. The number of women diagnosed with cancer is around 1400.

The Pap test detects changes in the cells of the cervix. The cervix is the opening to the uterus at the end of the vagina. A doctor or nurse practitioner takes a sample of cells from an area on the cervix called the transformation zone. This zone divides the cells of the cervix from different ones in the uterus. This is an area vulnerable to abnormal changes.

Changes in the cells could be a result of:

  • a vaginal infection or sexually transmitted infection (STI);
  • human papilloma virus (HPV), which is a specific sexually transmitted infection–some types of HPV are linked to serious cervical changes and cervical cancer;
  • being daughter of women who took DES (diethylstilbestrol) during pregnancy; or
  • hormonal changes that happen to post-menopausal women.

I am frightened by an abnormal Pap test result

Most women experience some anxiety when they are told they have abnormalities. Remember that most women with an abnormal test result do not have cancer. Talking to someone you trust might help you deal with your fear and anxiety.

Most cervical cancers take ten years to develop. Many cervical abnormalities return to normal (regress) within one to two years. You should not panic and may not need to rush into procedures and treatment. Consider all your options.

What does an abnormal Pap result mean?

An abnormal Pap test does not mean you have cervical cancer. Approximately four million Pap tests are done every year in Canada. About 8% (over 325,000) have abnormal results. The number of women diagnosed with cancer is around 1400.

The Pap test detects changes in the cells of the cervix. The cervix is the opening to the uterus at the end of the vagina. A doctor or nurse practitioner takes a sample of cells from an area on the cervix called the transformation zone. This zone divides the cells of the cervix from different ones in the uterus. This is an area vulnerable to abnormal changes.

Changes in the cells could be a result of:

  • a vaginal infection or sexually transmitted infection (STI);
  • human papilloma virus (HPV), which is a specific sexually transmitted infection–some types of HPV are linked to serious cervical changes and cervical cancer;
  • being daughter of women who took DES (diethylstilbestrol) during pregnancy; or
  • hormonal changes that happen to post-menopausal women.

I am frightened by an abnormal Pap test result

Most women experience some anxiety when they are told they have abnormalities. Remember that most women with an abnormal test result do not have cancer. Talking to someone you trust might help you deal with your fear and anxiety.

Most cervical cancers take ten years to develop. Many cervical abnormalities return to normal (regress) within one to two years. You should not panic and may not need to rush into procedures and treatment. Consider all your options.

Getting the whole story about abnormal results

Ask your doctor or nurse practitioner to show you the written report. Across Canada there are several systems for classifying abnormal Pap test results. You will also find a description of the abnormality. This information can help you make decisions about your care.

Your test result says

What does this mean?

What usually happens next?

Unsatisfactory smear

1. The doctor or nurse practitioner did not take an adequate sample.

2. If you are pregnant or take oral contraceptives hormonal changes may influence the smear quality.

Repeat test in three months. This is the minimum time needed to replace new cells on the cervix.

Benign or reactive changes

or

Mild atypia

Your cervix is normal.

You may have a vaginal infection or sexually transmitted infection.

Treat any infection or wait for active virus like Herpes to pass. Then repeat Pap test in six months.

ASCUS(atypical squamous cells)

or

AGUS(atypical glandular cells) of undetermined significance

Cells cannot be classified. Most ASCUS regress or return to normal on their own.

You may be infected with HPV.

You may have an HPV test.

Repeat Pap test in six months.

LSIL(low-grade squamous intraepithelial lesion)

or

mild dysplasia

or

CIN 1

These changes need to be watched. Most regress or return to normal. For women under 34 approximately 80% regress. For older women approximately 40% regress.

Cell changes may be caused by low hormone levels in menopausal and postmenopausal women.

You may be referred for colposcopy.

Or you could repeat the Pap test in six months. In that time you could try self-help options.

(See FAQ on Procedures and Treatments for Cervical Abnormalities)

Doctors may prescribe estrogen cream for a few weeks to clarify the cause of cell changes.

HSIL(high-grade squamous intraepithelial lesion)

or

Moderate to severe dysplasia

or

Carcinoma in situ

or

Adenocarcinoma in situ

or

CIN 2 or CIN 3

These are more severe abnormal results. This still is not cancer. No one can tell if they will progress or regress. You may be at risk of developing cervical cancer.

Colposcopy will be recommended.

Or you could repeat the Pap test in six months. In that time you could try self-help options.

(See FAQ on Procedures and Treatments for Cervical Abnormalities)

Squamous Carcinoma

These results indicate the presence of cancerous cells.

Colposcopy will be recommended immediately.

Where can I go for more information?