What does that abnormal pap smear mean?
WOMEN are often told that once sexually active they should do routine pap smears, or have them conducted yearly after their 21st birthday, to determine if they are at risk of developing cervical cancer.
But gynaecologist Dr Ryan Halsall said pap smears don’t necessarily look for cancer, but are used to detect abnormal changes of the cervix before they turn to cancer.
“Current guidelines recommend one every three years, once they have been normal in the past,” he said.
Dr Halsall said a normal smear means there were no cancerous, pre- cancerous or other abnormal cells seen.
On the other hand, an abnormal pap could mean that the cervix is infected, inflamed or contains pre-cancerous lesions.
“Infections or inflammation include yeast, trichomoniasis and bacterial vaginosis. These can all be detected on a routine pap smear. STIs such as gonorrhoea and chlamydia, however, will not be detected,” Dr Halsall said.
He added that if your pap smear repeatedly shows inflammation, you should get further evaluation, as inflammation can sometimes mask cancerous changes.
Dr Halsall said these abnormalities vary in type and severity, and the action taken is dependent on what exactly is found.
“The most common abnormality seen is ‘abnormal squamous cells of undetermined significance (ASCUS)’. Fortunately, this requires nothing more than either HPV testing or repeating the test. Higher grade lesions require more detailed and relatively painless examination of the cervix, via a procedure called colposcopy, along with biopsies of the affected area,” he said.
Dr Halsall added that abnormal smears should always be reviewed by your OBGYN, who will guide you in making an informed decision on further management.
Gynaecologist Dr Charles Rockhead said following an abnormal pap smear, self-care by a medical practitioner is needed.
“If the results were abnormal, a qualified medical practitioner should advise you as to your next step. Usually tests that show ASCUS abnormality require repeat testing and further investigation every six months to a year. If the test returns an AGUS [atypical glandular cells of undetermined significance], it means that some of the glandular cells that produce mucus in the cervix and uterus are abnormal, but it is unknown whether cancer is present. Further investigations or a colposcopy is done.”
He added that HPV and DNA testing can also be done to determine if HPV is present, and if it is cancerous or not.
