Guest Author - A. Maria Hester, M.D.



Cervical cancer can be devastating, and ultimately fatal. Fortunately, there is a great screening test that can detect cervical cancer early, when it has a very high cure rate. The Pap smear (also called the Pap test) is relatively painless and very safe. Women should start having regular Pap smears no more than 3 years after they start having vaginal intercourse, and no later than by age twenty one.

Potential Risks:
Pap smears are associated with very low risk of complications because they simply entail gently scraping the cervix during a routine pelvic examination. Nevertheless, on occasion there may be mild bleeding after a pap smear, but this is rarely of much significance.

Classification:
In the past, there were different classification systems for reading Pap smears. However, today Pap smears analysis is standardized regardless of which lab does the test. The current system is called TBS, which stands for The Bethesda System.

Terms your physician may use to explain your results:

Normal or within normal limits is great. There is no evidence of any abnormality of your cervical cells.

ASCUS means atypical squamous cells of undetermined significance. As the name implies, we do not yet fully understand the significance of these abnormal appearing cells. Of all the abnormal results, ASCUS is the least significant, clinically speaking. Squamous cells are a type of cell found in the vaginal and cervical regions, as well as other places in the body.

LSIL refers to low-grade squamous intraepithelial lesion. This abnormality is more serious than ASCUS and it requires further investigation. While it is recommended that all women with LSIL undergo colposcopy (an office procedure which gives more information than a routine Pap smear), in many women, LSIL returns to normal tissue spontaneous in a matter of months, without any therapy!

HSIL means high-grade squamous intraepithelial lesion. This is the most severe form of cellular abnormality seen on Pap smears. However, it does not mean a woman has cancer. While it is definitely a cause for concern, only 1-2% of women with HSIL turn out to have cervical cancer on biopsy.

Cervical Intraepithelial Neoplasia, or CIN, is a serious form of HSIL. CIN runs the spectrum from type 1 thru type 3, with type 1 being the least serious and type 3 being the most serious.

Carcinoma in situ is the worst form of HSIL. Carcinoma in situ is the name for cervical cancer that appears to be confined to the cervix and has not spread. Therefore, the potential for complete cure is very good.
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