Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
The health care professional will send a letter with test results. If there is a problem, the woman's
health care professional may contact her. For peace of mind, she can also call the
medical office to get the results. Before leaving after the exam, she can ask how long it takes the office to receive the lab report.
A negative or normal test finding means that the cervix looks healthy. All the cells are of a healthy size and shape.
A positive or abnormal test finding means that something unusual is in the sample. The test found cells of a different size and shape.
An abnormal Pap smear result does not always indicate cancer. Cells sometimes appear abnormal but are not cancerous. The woman will have to return to the
doctor for follow-up care.
An infection of the cervix may cause an abnormal test result. A
gonorrheal infection can cause the cervical cells to appear inflamed. After the infection is treated, the Pap smear result usually returns to normal.
If the Pap smear result is positive because of an infection, the underlying cause should be treated. The test should then be repeated in 2-3 months, because cancer of the cervix can be hidden by an infection. A check-up with a doctor is necessary.
Most laboratories in the United States use a standard set of terms called the Bethesda System to report, or interpret, test results. Under the Bethesda System, Pap smear samples that have no cell abnormalities are reported as "negative for intraepithelial lesion or malignancy" (meaning the woman does not have cancer).
Samples with cell abnormalities fall into the following categories (as outlined by the National Cancer Institute):
ASC (atypical squamous cells): Squamous cells are the thin, flat cells that form the surface of the cervix. The Bethesda System divides this category into the following
ASC-US (atypical squamous cells of undetermined significance): The squamous cells do not appear completely normal, but doctors are uncertain what the cell changes mean. Sometimes the changes are related to HPV infection. ACS-US are considered mild abnormalities.
ASC-H (atypical squamous cells cannot exclude a high-grade squamous intraepithelial lesion): The cells do not appear normal, but doctors are uncertain what the cell changes mean. ASC-H may be at higher risk of being precancerous.
AGC (atypical glandular cells): Glandular cells are mucus-producing cells found in the endocervical canal (opening in the center of the cervix) or in the lining of the uterus. The glandular cells do not appear normal, but doctors are uncertain what the cell changes mean.
AIS (endocervical adenocarcinoma in situ): Precancerous cells found in the glandular tissue.
LSIL (low-grade squamous intraepithelial lesion): Low-grade means there are early changes in the size and shape of cells. The word lesion refers to an area of abnormal tissue. Intraepithelial refers to the layer of cells that forms the surface of the cervix. LSILs are considered mild abnormalities caused by HPV infection.
HSIL (high-grade squamous intraepithelial lesion): High-grade means that there are more marked changes in the size and shape of the abnormal (precancerous) cells, meaning the cells look very different from normal cells. HSILs are more severe abnormalities and have a higher likelihood of progressing to invasive cancer.