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Pap Test Results and Terms

Understanding Pap Smear Results

If you have an abnormal Pap test result, some of the terms used can be confusing and may be a cause for concern if the meaning is not clear. So Women First wants you to know how we define Pap test results to help you understand the terminology being used and what follow-up may be needed.

The cytologist report at Women First uses the “Bethesda System” to describe Pap test results. This system uses the term squamous intraepithelial lesion (SIL) to describe pre-cancer changes. “Squamous” refers to the type of cells that make up the tissue that covers the cervix. With this system, your results will be placed in one of several groups:

  • Normal (negative)—there are no signs of cancer of pre-cancer.
  • Atypical Squamous Cells of Undetermined Significance (ASCUS)—changes in the cervical cells have been found. HPV typing may be indicated depending upon age and, if positive, would then result in a recommendation for a colposcopy.
  • Low Grade changes (LGSIL) or Mild Dysplasia almost always indicates that an HPV infection is present, but it also may indicate mild pre-cancer changes. This would then require a colposcopy with or without a biopsy, depending upon findings on exam. LGSIL is very common and usually goes away on its own without treatment.
  • High Grade changes (HGSIL) or Severe Dysplasia indicates more serious changes. This would require a colposcopy exam with biopsy.
  • Atypical Squamous Cells cannot exclude High Grade (ASC-H)—changes in the cervical cells have been found. These changes are not clearly HGSIL but could be. This would require a colposcopy exam with biopsy.

Your doctor may recommend colposcopy if your Pap test result is abnormal.

  • Colposcopy—During a colposcopy, your doctor uses a special instrument called a colposcope, which is a special magnifying device used to view the cervix, vulva, and vagina. This exam allows your doctor to view cells that cannot be seen by the eye alone. If your doctor finds an unusual area of cells during your colposcopy procedure, a sample of tissue will be collected for laboratory testing (biopsy).

The main cause of abnormal Pap test results is infection with the Human Papilloma Virus (HPV).

  • HPV (genital Human Papillomavirus) is the most common sexually transmitted infection. HPV is usually harmless, and most of the time it will go away by itself, but some types can lead to pre-cancer, cancer, or genital warts. Genital HPV infections are very common. In fact, most people who have sex get exposed to HPV at some point in their lives. Most people with HPV have no symptoms and feel totally fine, so they may not know they are infected. For problematic HPV, there are many treatment options, and your Women First provider will work with you to recommend the ones that are best for you.
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