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Your Pap Smear is Abnormal . . . Now What?

March, 2019 | Northside Woman Magazine | NorthsideWoman.com | By Dr. Annie Kim, MD, FACOG

Modern OBGYN Featured in Northside Woman Magazine March 2019Cervical cancer is the easiest gynecologic cancer to prevent, with regular screening tests and followup. There are currently two screening tests that can help prevent cervical cancer or detect it early. The Pap smear looks for precancerous changes on the cervix that might become cervical cancer if not treated appropriately. The HPV test detects the human papillomavirus that can cause these cellular changes. The Pap smear is recommended for all women between the ages of 21 and 65 years old, and this test can be done in your doctor’s office.

If your Pap smear is normal, then routine followup is recommended as recommended by your doctor. An abnormal Pap smear is one in which the laboratory interprets the cellular changes to be different from those normally seen on a healthy cervix. Although an abnormal test result can be worrisome, it does not necessarily mean you have cervical cancer. Of the 3 million women who receive an abnormal result from a Pap smear each year, only about 10,000 are actually cases of cervical cancer.

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There are a few conditions that might cause an abnormal Pap smear result, including HPV, which is the most common cause. HPV is a common sexually transmitted infection, and most sexually active individuals have been exposed to at last one of the more than 100 known strains of HPV. Other sexually transmitted infections, including gonorrhea and chlamydia, as well as vaginal inflammation from bacterial vaginosis or a yeast infection can also cause changes on your Pap smear.

If you have an abnormal Pap smear, your doctor will probably ask you to come back for a follow-up appointment for a procedure called a colposcopy. Colposcopy is an outpatient procedure where your doctor takes a closer look at the cervix using a special instrument called a colposcope, which combines a bright light and magnifying lens. If abnormal cells are seen, then a biopsy is performed and sent to the lab to determine whether these cells are cancerous or precancerous. The type of cells that are found on biopsy will dictate the treatment. Moderate to severe precancerous cells need to be removed by procedures such as conization or loop excision, but if the biopsy is completely normal, then more frequent Pap smears would be recommended. The most important thing to know about an abnormal Pap smear is that as long as you follow-up with all of the recommended testing, you are not likely to develop cervical cancer. Therefore, it is crucial to be proactive about your health and schedule well-woman visits with your gynecologist every year.