Abnormal PAP smear

The PAP test is a very effective screening tool for Cervical abnormalities. However, the PAP test is not a diagnostic test. If the PAP is abnormal then additional tests or a plan of follow-up is necessary. Abnormal PAP tests are generally placed into one of 6 categories.

1)    Low Grade Squamous Lesions: These include Atypical Squamous Cells and Mild Dysplasia. This group is the least serious but still need either additional testing or a plan for follow-up. If confirmed, this category does not generally need treatment and will most commonly return to normal on its own.

2)    High Grade Squamous Lesions: This category includes Moderate and Severe Dysplasia. These are serious pre-cancer cells and most commonly need to be treated. A microscopic exam of the Cervix called Colposcopy is typically performed in the office to confirm the diagnosis prior to planning treatment.

3)    Carcinoma-In-Situ: These represent true Cancer cells but ones that are superficial and have not invaded the body. A colposcopy exam is again performed prior to planning treatment.

4)    Cancer of the Cervix: This is obviously the most serious category. Besides Colposcopy, these patients often need to have a wedge shaped biopsy performed called conization that helps determine the extent of Cancer. We refer all of our patients with a diagnosis of invasive cancer to Dr Tom Morgan. Dr Morgan is a member of our group who has completed a fellowship in GYN-Oncology so he specializes in the treatment of cancer.

5)    Abnormal Glandular Cells: This is a less common result on PAP smears but can cover the same ranges as Squamous cells. The Glandular cells are further up in the Cervical canal. A colposcopy exam is recommended to determine the extent of the problem before planning treatment.

6)    Infections of the Cervix can also be detected at times by the PAP test. Some of these infections can be treated and some need additional evaluation before treatment.
An Abnormal PAP test is often very frightening. Please realize that the cells do not change rapidly. We will help make recommendations about how to appropriately evaluate the situation as well as discuss follow-up and/or treatment options.

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