What if abnormal cells are seen on my Pap smear?

Results from five to 10% of Pap smears performed each year on women in the United States are reported as abnormal. Abnormal cell types include:

• ASCUS-atypical squamous cells of undetermined significance. Squamous cells are the thin flat cells that form the surface of the cervix.
• LSIL-low-grade (early changes in the size, shape, and number of cells) squamous intraepithelial lesion. The word lesion refers to an area of abnormal tissue; intraepithelial means that the abnormal cells are present only in the surface layer of cells.
• HSIL-high-grade squamous intraepithelial lesion. High-grade means that there are a large number of precancerous cells that look very different from normal cells.

ASCUS and LSIL are considered mild abnormalities. HSIL is more severe and has a higher likelihood of progressing to invasive cancer.

If the Pap test abnormality is unclear or minor, the doctor may repeat the test to ensure accuracy. If the Pap test shows a significant abnormality, the doctor may then perform a test called a colposcopy. For this test, the doctor uses a magnifying instrument to view the tissue surrounding the vagina and cervix to check for any abnormalities. A Schiller test may also be performed. For this test, the doctor coats the cervix with an iodine solution. Healthy cells turn brown and abnormal cells turn white or yellow. Both of these procedures can be done in the doctor's office. Finally, the doctor may also remove a small amount of cervical tissue for examination. This procedure is called a biopsy and is the only sure way to know whether the abnormal cells indicate cancer.