Abnormal Pap Smear

According to the American Cancer Society, nearly 13,000 women in the United States are diagnosed with invasive cervical cancer every year, resulting in more than 4,000 deaths annually.  Primarily striking women in their prime—most cases are diagnosed in women between the ages of 20 and 50, while more than 15% of cases occur in women over 65—cervical cancer rarely exhibits noticeable symptoms until it begins to spread to other areas of the body, making effective treatment significantly more difficult.  Yet over the past thirty years, the death rate from cervical cancer has declined by more than 50% thanks to the Pap smear, a highly effective screening mechanism that enables physicians to detect pre-cancerous changes in the cervix before they can develop into cervical cancer, as well as detect the presence of cancerous cells early in their formation, making treatment significantly more effective.

The Board Certified gynecologists at Commonwealth OB-Gyn, located in Brookline Village near downtown Boston, MA, recommend that every woman undergo an annual Pap screen as part of her routine women’s wellness exam, starting at the age of 21.  This painless screening requires collection of a small sample of cells from the opening of the cervix, and is usually conducted in conjunction with a visual pelvic exam and a blood test for human papillomavirus (HPV), the presence of which has been found to be a risk factor in the development of cervical cancer.  Once the collected cells have been analyzed and tested, our team of warm, caring physicians will ensure that you understand the results of your Pap smear, and in the case that abnormalities are detected, we will work closely with you to schedule any required follow-up tests and necessary treatments.


What happens if my Pap smear comes back “abnormal”?

A Pap smear is a screening mechanism only, not a diagnostic test.  An “abnormal” or “positive” Pap smear does not mean that you have cervical cancer.  It simply indicates that unusual cells have been detected on the cervix and that additional diagnostic testing may be required.  These unusual cells can include:

  • Atypical Squamous Cells of Undetermined Significance (ASCUS): “Squamous” cells are thin, flat cells found on the surface of a healthy uterus, and if abnormalities are detected without the additional presence of HPV, they are not usually an indicator of cervical cancer.    
  • Atypical Glandular Cells: Glandular cells are found in the opening of the cervix and in the uterus.  Should atypical cells be detected by the Pap smear, your physician will most likely schedule additional testing to determine the significance of the abnormalities.  
  • Squamous Intraepithelial Lesion: The detection of lesions may indicate the presence of precancerous cells, requiring additional diagnostic testing for cervical cancer.
  • Squamous Cell Cancer or Adenocarcinoma Cells: The discovery of either of these two forms of precancerous cells will require immediate follow-up diagnostic testing, evaluation, and treatment for the earliest phases of cervical cancer.


Follow-Up Testing and Treatment after an Abnormal Pap Smear

Any abnormal Pap smear will generally require additional follow-up testing, either to rule out the presence of precancerous cells or to conduct a more definite diagnostic test for cervical cancer.  The appropriate test(s) to perform will depend upon previous Pap smear results, the specific findings of your most recent Pap smear, and any other risk factors such as the presence of HPV.  Follow-up testing may include one or more of these routine procedures:

  • Colposcopy and Cervical Biopsy: A colposcopy is a visual examination of the cervix using a low-powered magnifying device (colposcope) to magnify the cervix and uterus.  This exam enables your clinician to detect, photograph, and take samples of any abnormal tissues for diagnostic testing in the lab.
  • Loop Electrosurgical Excision Procedure (LEEP): The LEEP utilizes a gentle electrical current to help diagnose and treat abnormal cervical cells.  When targeted at abnormal cells, the current rapidly heats them, causing them to burst.  The excised tissue is sent for additional diagnostic testing to accurately assess the abnormality and to ensure its complete removal.
  • HPV Testing: Blood work to check for the presence of the HPV virus types that have been most closely linked to an increased risk of cervical cancer.


Contact Commonwealth OB-Gyn

If you are concerned about an abnormal Pap smear and would like to follow up with one of our Board Certified gynecologists, or if you would like to learn more about Commonwealth OB-Gyn, our physicians, and our other services, we encourage you to schedule your appointment today.  We look forward to hearing from you!

Commonwealth Ob-Gyn