When Should You Worry About an Abnormal Pap Smear?

An abnormal finding is extremely common in a GYN's office. So how do you know when to be concerned?

The answer lies in whether you have HPV or not and how abnormal the cells on your pap smear look.

What is a pap smear anyway? It is a collection of cervical cells. It does NOT test for ovarian or endometrial(uterine) disease.

The pap smear can be divided into groups:

• Normal
• Atypical Cells (ASCUS)
• Mild Dysplasia or CIN I
• Moderate Dysplasia or CIN II
• Severe Dysplasia or CIN III
• Cervical Cancer

Dysplasia is the medical term for PRE-cancer (not actual cancer). The HUGE majority of abnormal smears is caused by HPV. Read further about HPV here.

Smoking can also contribute greatly to abnormal cells.

What Should Be Done About an Abnormal Smear?

If you have an abnormal smear AND have HPV, you need further testing.

The first step is a colposcopy. This is simply a big magnifying glass so the doctor can see your cervix up close. There are characteristics seen if you have dysplasia.

If these characteristics are present, usually a biopsy is performed. A biopsy will tell exactly if you have dysplasia.

Don't worry....the biopsy is very,very small and not to be feared.

How Do You Treat an Abnormal Smear?

If you have ASCUS but are HPV negative, relax. You probably just need a repeat pap smear in about 6 months depending on your past history.

If you have dysplasia,it depends on the severity of the dysplasia. Treatment may be recommended. Sometimes just observation is enough.

For moderate to severe dysplasia, the most common treatment is a LEEP. This essentially is a hot wire that removes the dysplasia. It can be done in the office or as a day surgery.

Other treatments include freezing or laser.

Most importantly, you MUST have follow-up pap smears usually at 3-6 month intervals for a period of time.