Abnormal pap smears

What does my Pap test result really mean?

Most Pap tests come back normal, but it's not out of the ordinary for the Pap test to be abnormal if you or your daughter is an adolescent. Cancer is usually not the reason a test would be abnormal.

Possible results of a Pap smear:

• Normal
  • Your daughter will need another Pap smear in one year.
• Unsatisfactory
  • For some reason, the cell sample was not sufficient to be analyzed, and your daughter will probably need to repeat the test.
• Benign changes
  • Her test was basically normal, but she might have an infection causing inflammation of her cervical cells.
  • Her health care provider will do a pelvic exam and possibly schedule another test.
• ASCUS (which is short for "Atypical Squamous Cells of Undetermined Significance")
  • This result means there were some abnormal cells in the test and another test will be needed to check if Human Papillomavirus (HPV) is the cause.
  • If your daughter is over age 21, a test called HPV DNA screening is done to check if she is positive for one of the many types of HPV that may cause serious cervical disease.
  • If your daughter is under 21, and this is her first abnormal Pap test, (and she doesn't have special health problems, such as taking steroids, HIV or other immune problems),her health care provider will want to repeat the Pap test in one year to see if the abnormal cells are still there. This is because low-grade cervical lesions in girls under 21 usually resolve without treatment.
• ASCUS-H
  • This is the same result as ASCUS, but the "-H"at the end of this abbreviation means that there is a good possibility that "high-grade changes" may be the cause of the problem. She will need to have a colposcopy, which is really just a long pelvic exam.
• LSIL (Low Grade Squamous Intraepithelial Lesion)
  • This result usually means her cervical cells are infected with HPV.
  • If your daughter is over 21, she will be referred for a colposcopy.
  • If your daughter is under 21, and this is her first abnormal Pap test and she doesn't have other health problems,her health care provider will want to repeat the Pap test in one year. This is because low-grade cervical lesions in girls under 21 usually resolve without treatment.
• HSIL (High Grade Intraepithelial Lesion)
  • This means her cervical cells have made changes beyond the "low-grade" changes. She probably doesn't have cancer now, but without treatment, she is at risk for developing cervical cancer. She will be referred for a colposcopy.
• AGC (Atypical Glandular Cells)
  • This result means that there are changes in the glandular cells of the cervix. She will need a colposcopy.
• Cancer
  • Although cancer is very rare in young women, if her Pap test comes back showing cancer cells, she will be referred to an oncologist at Children's. Treatment is necessary right away and usually includes surgery. The earlier the treatment, the better her chances of staying healthy. 

The Center for Young Women's Health website is a great source of information about abnormal Pap results.

What if my daughter's doctor wants her to have colposcopy?

• If your daughter is referred for a colposcopy, she can expect a procedure similar to the Pap smear. It is essentially just a long pelvic exam that takes 15 to 20 minutes.
• The doctor will tell your daughter what he or she saw, but it usually takes two to three weeks for the results of the biopsy to come back.
• It's normal to have slight bleeding after the procedure, but if there is any severe pelvic pain or bright red bleeding, your daughter should call a doctor immediately.

Is there anything my daughter can do to prevent HPV and the risk of cervical cancer?

• The only way to truly avoid HPV infection is to not have sex.
• Two HPV vaccines have been developed, and clinical trials of these vaccines have been successful.
• One of the vaccines, Gardasil®, was approved by the US Food and Drug Administration in 2006 and can protect women from HPV infections. It protects against four types of the HPV virus, including the two viruses that cause 90 percent of genital warts.
• Gardasil can only be used to prevent HPV infection before an abnormal Pap test develops.
• Gardasil is administered as a series of three injections over a six-month period.