After the Procedure

The health care provider sends a letter with test results. If there is a problem, the woman's provider may contact her. For peace of mind, she can also call the clinic 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 clinic for follow-up care.
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• Remember that abnormal conditions do not always become cancerous, and some conditions are more of a threat than others.
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• An infection of the cervix may cause a positive test result. A yeast, trichomonas, chlamydial, or gonorrheal infection can cause the cervical cells to appear inflamed. After the infection is treated, the Pap smear result usually returns to normal.
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• Human papillomavirus (HPV) can also cause a test result to be positive. This virus may exist on the cervix or in the vagina and causes genital warts. Many types of HPV have been identified, and some are associated with cervical cancer. If the woman has HPV, she has a higher risk of developing cervical cancer.
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• The smear result may be positive because it shows changes that may become cervical cancer.
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• If a woman has an abnormal Pap smear result, a repeat test should be done every 4-6 months for 2 years until 3 consecutive negative tests have been obtained.
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• 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.
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• Although the Pap smear is the best method of detecting cervical cancer early, it is not perfect. Because even the best labs can miss some cell changes, a woman should have the test performed yearly, as the American Cancer Society recommends.
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• Recently, 2 computerized systems (PAPNET and AutoPap) have been approved by the US Food and Drug Administration to detect abnormal cells from a Pap smear. To ensure accuracy of the test, they use computer technology to recheck Pap smears for abnormal cells the technician may have missed. These tests cost more than a normal Pap smear, but they can be helpful if the woman is at high risk for cervical cancer. Consult a doctor about these methods.

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 2 groups:
  
  
  • 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.
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  • 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.
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• 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.
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• AIS (endocervical adenocarcinoma in situ): Precancerous cells found in the glandular tissue.
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• 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.
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• 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.