Abnormal Pap Smear – Causes and Treatment
A Pap smear test (Papanicolaou test), or just a Pap test, is an uncomplicated procedure that is used to find abnormal cells in the cervix (The lowest part of your uterus which is located at the top of the vagina). They are not necessarily used as diagnostic tests but as screening tests which tell about any abnormal cell developments or dysplasia in the cervix.
An abnormal Pap smear indicates that there has been an undesirable change in the cell composition or the formation of abnormal cells in the cervix. The Pap Smear test should be included in a woman’s routine physical exam because any abnormality may be indicative of cervical cancer. Although, having an abnormal Pap smear, doesn’t always mean you have cancer. In fact, the chances are very low.
We at Apollo Spectra, believe that every patient shall be aware about what the procedure entails and what risks are involved in the procedure. We also ensure that our patients are received with the best care and state-of-the-art facilities are provided to them.
According to studies, 21 is the perfect age for getting started on regular Pap smear tests as it is the most reliable test for screening and detection of cancer. There is no essential preparation before going for a Pap test, but there remain a few things which may inadvertently affect the results. For better and accurate results, the following things should be avoided for 48-50 hours before going for the test:
• Sexual intercourse
• Vaginal creams, medicines, powders, sprays or other female hygiene products
A Pap Smear Test can be performed at any time of the month and even during the menstrual flow, but it is better to go in between the flows, that is, from the proliferative to the secretory phase (7-28 days).
There are no other pre-requisites for getting a Pap Smear test and it shouldn’t take more than a few minutes.
In a Pap smear test, a sample of mucus and cells are taken from the cervix and the endocervix using a cervical brush or a wooden scraper.
An abnormal Pap Smear may indicate towards various things like:
• Recent sexual activity
• Infection or inflammation
• HPV (Human Papilloma Virus) or Genital Warts
HPV is the most common cause of an abnormal Pap Smear which is a sexually transmitted infection (STD).
Although, more often than not, these cell changes get cured on their own with no lasting impact. But there still remain certain HPV that have been linked to cervical cancer. This makes regular Pap Smear tests very important so as to detect any carcinogen in its early stage.
Apart from this, the change in the cell composition can also occur due to various types of infections caused by bacteria or yeasts which can be treated pretty easily.
In some cases, where women have gone through menopause, an abnormal Pap test may simply be a result of old age.
Test results can also be inconclusive. This is called atypical squamous cells of undetermined significance or ASCUS. Which means that the cells did not appear normal and yet were not necessarily abnormal. In 75% of such cases, the cells are later found to be normal. This can also result from a poor sample which may happen due to recent sexual activity or the use of feminine hygiene products.
According to researches, Cervical cancer poses one of the most frequent cases of cancer in India. Females above the age of 15 are at a risk of developing cervical cancer. Every year in India, 122,844 women are diagnosed with cervical cancer and 67,477 die from the disease. Hence it becomes extremely important to detect abnormality in Pap Smear as early as possible. HPV can be contracted by certain sexual acts, like unprotected intercourse, having multiple sex partners or having sex with a partner who in turn has multiple sex partners. These increase the risk of contracting HPV which may result in having an abnormal Pap smear test.
Furthermore, testing positive for HPV does not imply recent unprotected sex or multiple partners because HPV can stay in your body for many years without showing any symptoms. So even if you practice safe sex and have just one partner, your pap smear test may still be abnormal if you were exposed to HPV in the past.
Apart from this, smoking and a marred immune system also raise the chances of having an abnormal change in your cervix.
Some women may not run the risk of abnormal Pap Smear. Like women over the age of 65 who have never had an abnormal test result in 10 years. Or, women who have gotten their uterus and cervix removed (hysterectomy) and didn’t have a history of abnormal Pap smear before.
The cell change alone does not cause any symptoms, which is also the case with HPV which is the underlying reason for most of the abnormal Pap tests. Hence the test assumes an important role in finding and treating an abnormal Pap Smear.
If the abnormality has been caused by a different sexually transmitted infection, there might be some symptoms:
• An irregular vaginal discharge which is not normal for you, such as the colour, odour or texture.
• Sores, rashes, blisters, lumps or warts, on or around your genitals.
• Pain, itching or burning in your pelvic or the genital area while intercourse or urination.
After an abnormal Pap test, you may need further tests to locate the problem (Bacterial infections or HPV) and the severity of the cell change.
• Colposcopy, a procedure to examine the vagina and cervix through a lighted microscope or any magnifying tool.
• An HPV test, done in the same way as a Pap test by taking a sample of cells from the cervix.
• Follow-up Pap test in 6 months to a year.
A colposcopy is usually done before treating a patient, during which the doctor biopsies a sample tissue from the cervix, this is called cone biopsy. The treatment depends on the severity of the cell change (mild, moderate or severe).
In moderate or severe cases, the treatments given are to destroy or remove the abnormal cells. This can be done by freezing the abnormal cells (known as cryosurgery) or removing them using “Loop Electrosurgical Excision Procedure” or simply, LEEP. Cancer can be prevented from ever developing by removing these abnormal cells.
Although, if the biopsy confirms cancer, further treatments depend on other factors like stage and grade of tumor.
The primary motive of a Pap Smear test is to find abnormal cell growth before they get cancerous. Hence the following prevention steps should be considered:
• Get vaccinated (for HPV)
• Practice safe sex
• Get regular Pap smear tests
At Apollo Spectra, each procedure is essential and each procedure is performed with utmost precision and care. We ensure that our patients are comfortable and their health and safety is our priority. Each test is performed very carefully, and we also provide further tests like colposcopy or an HPV test, in case your pap smear comes out to be abnormal. We also offer follow up Pap tests, to ensure that you are at the best of your health, at all times. With the advanced technology and equipment, all testing is done very thoroughly.
Is it safe to get a Pap smear test during pregnancy?
It is completely safe to have a Pap smear test during pregnancy.
What if the test shows abnormal Pap smear during pregnancy?
If the results are abnormal during pregnancy, a colposcopy can be performed. Although, further treatments will be delayed until the baby is born. Having an abnormal Pap smear does not pose any risk to the child.
What check-ups are necessary after treatment?
Check-ups following a treatment are necessary to keep track of the cell growths and the remission. The consulting doctor would advise on the frequency of routine Pap smear tests.
Can I get a walk-in diagnosis at Apollo Spectra?
Apollo Spectra believes in the comfort of the patients and their families and hence we offer the entire range of treatments from diagnosis to the treatments.