Abnormal Pap Smear

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On occasion, the Pap smear will show abnormal cells, called a squamous intraepithelial lesion (SIL). An abnormal Pap smear is not a diagnosis of cancer or even pre-cancer. It is merely an indication that additional testing is needed. The type of additional testing depends on the severity of the abnormality and the patient’s age.

The most common type of abnormal result is termed “atypical cells of uncertain significance” (ASC-US). Usually this indicates the need for a test for HPV, which is the most common virus associated with abnormal cervical cells and cervical cancer. If that test is negative, then further testing is not needed until the next regularly scheduled Pap smear.

 

If the HPV test is positive, or if more severe abnormalities are detected in the Pap smear, then colposcopy (inspection of the cervix with a microscope) is indicated, with biopsy of areas that appear abnormal. This is a minor office procedure.

 

If this testing reveals a high-grade abnormality, then treatment is indicated. There are two basic types of treatment, excision (removal) of the abnormality or ablation (freezing) of the abnormal area. The choice of treatment depends on several factors and we will explain the options and together we can make the best decision for your situation.

Human Papilloma Virus and HPV Vaccines

Human papilloma virus (HPV) is very common among both men and women and is commonly transmitted through vaginal, anal, or oral sex. It has been linked with the development of cervical cancer and genital warts. There are more than 100 types of HPV: some are associated with genital warts and others are associated with cervical cancer.

 

There are 3 HPV vaccines now available. They target genital warts and the high-risk strains associated with cervical cancer. While these vaccines are very effective against certain strains, none of them prevents all HPV infections. The vaccines are recommended for girls and boys ages 9 through 26 years. They are given in 3 doses over 6 months. The vaccines are most effective in girls and boys before they become sexually active, but can be given in those who are already sexually active. However, they cannot prevent disease in those already infected with the strains of HPV targeted by the vaccine.