Help! I Have an Abnormal Pap!

If you’ve just received a call from your provider that your pap smear is abnormal, chances are you’re wondering what this all means. It’s perfectly normal and natural to have a million questions and to be so overwhelmed that you haven’t heard anything they said. I hope this information will reassure you

What are the possible results of a Pap Smear

Here are the possible results from having a pap smear.

1. Normal – No infection with HPV, completely normal cells

2. ASCUS – Atypical Squamous Cells of Undetermined Significance. This means that the cells are not normal, but they are not undergoing any pre-cancerous changes. 

– There may or may not be a positive High Risk HPV (HR HPV) result with this. 

3. LGSIL– Low Grade Squamous Intraepithelial Lesion – means that there is minimal changes from an HPV infection. This is also known as CIN 1 – Cervical Intra-epithelial Neoplasia. A provider may recommend treatment or to repeat the pap in 1 year.

4. HGSIL – High Grade Squamous Intraepithelial Lesion – means that there are moderate changes from an HPV infection. This is also known as CIN 2 – Cervical Intra-epithelial Neoplasia. A provider will likely recommend treatment.

5. CIN 3 – Cervical Intra-epithelial Neoplasia. This is severely abnormal finding and is considered a pre-cancerous condition. This will be treated so that it does not progress to cancer.  

6. Cervical Carcinoma – This is when the HPV infection has progressed, usually over 5-10 + years and become cancerous. This requires treatment. 

Why aren’t all High Risk HPV treated?

We used to treat all HR HPV very aggressively until we learned that the vast majority of these infections (90%) would go away on their own without treatment. 

We also learned that treatments to the cervix can increase the risk of infertility, premature labor and birth and pain. Now, we are working to minimize harm from treatment and identify those HR HPV that are more likely to progress. For this we use E6 and E7 testing to look for cancer causing proteins. This is an additional test your provider can ask for with no additional charge.