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Abnormal Pap Screens

Cervical cancer screening is used to find abnormal changes in the cells of the cervix that could lead to cancer. Screening includes the Pap test and, for some women, testing for a virus called human papillomavirus (HPV).

The main cause of cervical cancer is infection with HPV. Cells that are infected with HPV appear different from normal cells under a microscope. Abnormal changes can be mild or they can be more serious. The more serious changes can lead to cancer if not treated.

The different types of abnormal Pap test results include:

  • Atypical squamous cells of undetermined significance (ASC-US)—ASC-US means that changes in the cervical cells have been found. The changes are almost always a sign of an HPV infection. ASC-US is the most common abnormal Pap test result.
  • Low-grade squamous intraepithelial lesion (LSIL)—LSIL means that the cervical cells show changes that are mildly abnormal. LSIL usually is caused by an HPV infection that often goes away on its own.
  • High-grade squamous intraepithelial lesion (HSIL)—HSIL suggests more serious changes in the cervix than LSIL. It is more likely than LSIL to be associated with precancer and cancer.
  • Atypical squamous cells, cannot exclude HSIL (ASC-H)—ASC-H means that changes in the cervical cells have been found that raise concern for the presence of HSIL.
  • Atypical glandular cells (AGC)—Glandular cells are another type of cell that make up the thin layer of tissue that covers the inner canal of the cervix. Glandular cells also are present inside the uterus. An AGC result means that changes have been found in glandular cells that raise concern for the presence of precancer or cancer.

If you have an abnormal cervical cancer screening test result, you may need further testing. Such testing may include a repeat Pap test, an HPV test, a colposcopy, a biopsy, endocervical sampling or endometrial sampling.

Treatment

Nurse closing privacy curtain for patientIn general, there are two ways to treat abnormal cervical cells: 1) “excisional” treatment and 2) “ablative” treatment. With excisional treatments, tissue is removed from the cervix and sent to a laboratory to be studied. Results can tell whether changes are actually present and, if so, how severe they are. With ablative treatment, abnormal cervical tissue is destroyed, and there is no tissue to send to a laboratory for study.

Excisional treatments include:

  • Loop electrosurgical excision procedure (LEEP)—A thin wire loop that carries an electric current is used to remove abnormal areas of the cervix.
  • Conization—A cone-shaped piece of the cervix that contains the abnormal cells is removed.

Ablative treatments include:

  • Cryotherapy—An instrument is used to freeze abnormal cervical tissue, which then sloughs off.
  • Laser therapy—A focused beam of light is used to destroy abnormal cervical tissue.
Source: American College of Obstetricians and Gynecologists.