Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes
What is a Decision Point?
Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes? Get the facts Your options
Key points to remember
FAQs What is colposcopy?Colposcopy is a test that can find abnormal cells on your cervix, vulva, and vagina. During the exam, your doctor uses a magnifying device called a colposcope. This device allows your doctor to see problems that might be missed by the naked eye. If a problem is seen during the exam, your doctor may take a small piece of tissue (biopsy) from your cervix to take a closer look at the cells. Colposcopy may be done after a Pap test shows that you have minor cell changes on your cervix. An abnormal Pap test means that the test found some cells on your cervix that don't look normal. It doesn't mean that you have cancer. In fact, the chances that you have cancer are very small. What are your choices after a Pap test shows minor cell changes?All abnormal Pap tests require some kind of follow-up to be sure that the cell changes haven't gotten worse or have returned to normal. If you have atypical squamous cells of undetermined significance (ASC-US) cell changes, there are several follow-up options you can choose from. Most of the time, ASC-US cell changes stay the same or return to normal on their own. Women with ASC-US changes are not likely to get cervical cancer. Your choices of what to do next include:
If you're pregnant and have ASC-US cell changes, your choices are the same as those for women who aren't pregnant. Who may not need colposcopy?Most of the time, colposcopy is not advised for:
Instead, a period of watchful waiting and repeat Pap tests are tried first. What are the side effects or risks of colposcopy?Colposcopy is usually not painful, but it may cause some mild cramping. The tool (speculum) used to spread open your vagina is in place longer than during a routine pelvic exam. This may cause some discomfort. A biopsy may be done at the time of colposcopy. You may feel a brief, sharp pain or have some cramping while this is done. After the test you may:
Why might your doctor recommend colposcopy?Your doctor may recommend colposcopy if:
Compare your options Compare
Have colposcopy
Have colposcopy
Don't have colposcopy
Don't have colposcopy
Personal stories Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about treating minor cervical cell changesThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I was finishing school, starting a new job, and planning a wedding when the women's clinic called and said my Pap test was abnormal, with minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). She says I do not have any high-risk factors for cervical cancer and that waiting 4 to 6 months to follow up would be fine. I feel comfortable with her recommendation and have so much to do right now that watchful waiting feels okay. Indira, age 34 I started worrying as soon as my doctor called and said my Pap test was abnormal. She said the results showed only minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). I could follow up with another Pap test in 4 to 6 months. But I had just heard about a woman at my health club who was diagnosed with cervical cancer and is now undergoing treatment. With that fresh on my mind, I knew I couldn't wait 4 to 6 months to see if everything was okay. So I asked my doctor what else we could do. She said we could schedule a colposcopy examination as follow-up rather than waiting. April, age 29 I had an abnormal Pap test in my early 20s. My health professional at the time explained that an abnormal Pap is common in young, sexually active women. My tests have all been normal now for several years. I recently changed jobs and moved, so I didn't have a routine examination for almost 2 years. Now I have another abnormal Pap test, and the results classify the cell changes as ASC-US (atypical squamous cells of undetermined significance). My new health professional explained that further testing for high-risk human papillomavirus (HPV) types may determine how serious these cell changes are and help me decide what to do next. Because of my past health, it sounded reasonable to find out more. The HPV test was negative, which made me feel better. Now I only need follow-up Pap tests to monitor the cell changes. Margaret, age 32 I'm studying overseas for 3 months, so I had my regular gynecologic examination and Pap test at the student health clinic before leaving. The results showed minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). The health clinic nurse said that these changes are not usually treated and that follow-up Pap tests are usually all they recommend to monitor the minor cell changes. She reassured me that watchful waiting would be appropriate and told me to come back for a follow-up Pap test after I return home in 4 to 6 months. Aisha, age 22 My health professional just called with the results of my routine Pap test. I have some minor cervical cell changes classified as atypical squamous cells of undetermined significance (ASC-US). I've had sexually transmitted infections before, so I knew I might be at risk for an abnormal Pap test. He recommended that I have testing for the human papillomavirus (HPV) to determine if I have a high-risk HPV type. Further testing, such as repeat Pap tests or a colposcopy, will depend on the HPV test result. Since my husband and I want to start a family soon, it will be best to follow up now so we know what we're dealing with. Connie, age 32 I just had my first Pap test and found out I have cervical cell changes called low-grade squamous intraepithelial lesions (LSIL). My doctor says most women with these cell changes should have a procedure called a colposcopy to take a closer look at the cells. But since I'm still a teenager, the abnormal cells will probably not get worse. Instead of a colposcopy, I will have another Pap test in 4 to 6 months. Paola, age 16 What matters most to you? Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have colposcopy Reasons not to have colposcopy I'm worried that the abnormal cells may turn into cancer. I want to wait and see if the abnormal cells return to normal on their own. More important Equally important More important I'm not afraid to have a biopsy if my doctor sees a problem during the colposcopy. I don't want to have a colposcopy or biopsy if I don't need to. More important Equally important More important I'm not worried about how much colposcopy costs. I don't have insurance, and I can't afford to pay for the test myself. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now? Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Having colposcopy NOT having colposcopy Leaning toward Undecided Leaning toward What else do you need to make your decision? Check the facts 1.
Do most minor cell changes go away on their own?
2.
Is it okay to wait a while to see if the abnormal cells return to normal on their own?
3.
Can HPV infection cause minor cell changes to get worse?
Decide what's next 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty 1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. 3.
Use the following space to list questions, concerns, and next steps. Your Summary Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Your decisionNext steps Which way you're leaning How sure you are Your comments Your knowledge of the factsKey concepts that you understood Key concepts that may need review Getting ready to actPatient choices Credits and ReferencesCredits
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
1. Get the factsYour options
Key points to remember
FAQs What is colposcopy?Colposcopy is a test that can find abnormal cells on your cervix, vulva, and vagina. During the exam, your doctor uses a magnifying device called a colposcope. This device allows your doctor to see problems that might be missed by the naked eye. If a problem is seen during the exam, your doctor may take a small piece of tissue (biopsy) from your cervix to take a closer look at the cells. Colposcopy may be done after a Pap test shows that you have minor cell changes on your cervix. An abnormal Pap test means that the test found some cells on your cervix that don't look normal. It doesn't mean that you have cancer. In fact, the chances that you have cancer are very small. What are your choices after a Pap test shows minor cell changes?All abnormal Pap tests require some kind of follow-up to be sure that the cell changes haven't gotten worse or have returned to normal. If you have atypical squamous cells of undetermined significance (ASC-US) cell changes, there are several follow-up options you can choose from. Most of the time, ASC-US cell changes stay the same or return to normal on their own. Women with ASC-US changes are not likely to get cervical cancer. Your choices of what to do next include:
If you're pregnant and have ASC-US cell changes, your choices are the same as those for women who aren't pregnant. Who may not need colposcopy?Most of the time, colposcopy is not advised for:
Instead, a period of watchful waiting and repeat Pap tests are tried first. What are the side effects or risks of colposcopy?Colposcopy is usually not painful, but it may cause some mild cramping. The tool (speculum) used to spread open your vagina is in place longer than during a routine pelvic exam. This may cause some discomfort. A biopsy may be done at the time of colposcopy. You may feel a brief, sharp pain or have some cramping while this is done. After the test you may:
Why might your doctor recommend colposcopy?Your doctor may recommend colposcopy if:
2. Compare your options
Personal storiesAre you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about treating minor cervical cell changesThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "I was finishing school, starting a new job, and planning a wedding when the women's clinic called and said my Pap test was abnormal, with minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). She says I do not have any high-risk factors for cervical cancer and that waiting 4 to 6 months to follow up would be fine. I feel comfortable with her recommendation and have so much to do right now that watchful waiting feels okay." — Indira, age 34 "I started worrying as soon as my doctor called and said my Pap test was abnormal. She said the results showed only minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). I could follow up with another Pap test in 4 to 6 months. But I had just heard about a woman at my health club who was diagnosed with cervical cancer and is now undergoing treatment. With that fresh on my mind, I knew I couldn't wait 4 to 6 months to see if everything was okay. So I asked my doctor what else we could do. She said we could schedule a colposcopy examination as follow-up rather than waiting." — April, age 29 "I had an abnormal Pap test in my early 20s. My health professional at the time explained that an abnormal Pap is common in young, sexually active women. My tests have all been normal now for several years. I recently changed jobs and moved, so I didn't have a routine examination for almost 2 years. Now I have another abnormal Pap test, and the results classify the cell changes as ASC-US (atypical squamous cells of undetermined significance). My new health professional explained that further testing for high-risk human papillomavirus (HPV) types may determine how serious these cell changes are and help me decide what to do next. Because of my past health, it sounded reasonable to find out more. The HPV test was negative, which made me feel better. Now I only need follow-up Pap tests to monitor the cell changes." — Margaret, age 32 "I'm studying overseas for 3 months, so I had my regular gynecologic examination and Pap test at the student health clinic before leaving. The results showed minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). The health clinic nurse said that these changes are not usually treated and that follow-up Pap tests are usually all they recommend to monitor the minor cell changes. She reassured me that watchful waiting would be appropriate and told me to come back for a follow-up Pap test after I return home in 4 to 6 months." — Aisha, age 22 "My health professional just called with the results of my routine Pap test. I have some minor cervical cell changes classified as atypical squamous cells of undetermined significance (ASC-US). I've had sexually transmitted infections before, so I knew I might be at risk for an abnormal Pap test. He recommended that I have testing for the human papillomavirus (HPV) to determine if I have a high-risk HPV type. Further testing, such as repeat Pap tests or a colposcopy, will depend on the HPV test result. Since my husband and I want to start a family soon, it will be best to follow up now so we know what we're dealing with." — Connie, age 32 "I just had my first Pap test and found out I have cervical cell changes called low-grade squamous intraepithelial lesions (LSIL). My doctor says most women with these cell changes should have a procedure called a colposcopy to take a closer look at the cells. But since I'm still a teenager, the abnormal cells will probably not get worse. Instead of a colposcopy, I will have another Pap test in 4 to 6 months." — Paola, age 16 3. What matters most to you?Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have colposcopy Reasons not to have colposcopy I'm worried that the abnormal cells may turn into cancer. I want to wait and see if the abnormal cells return to normal on their own. More important Equally important More important I'm not afraid to have a biopsy if my doctor sees a problem during the colposcopy. I don't want to have a colposcopy or biopsy if I don't need to. More important Equally important More important I'm not worried about how much colposcopy costs. I don't have insurance, and I can't afford to pay for the test myself. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Having colposcopy NOT having colposcopy Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?Check the facts1. Do most minor cell changes go away on their own?
That's right. Most minor cell changes go away on their own and don't cause problems. And they are not usually cancer. 2. Is it okay to wait a while to see if the abnormal cells return to normal on their own?
That's right. More severe changes aren't likely to occur during a short period of watchful waiting. 3. Can HPV infection cause minor cell changes to get worse?
That's right. Some types of HPV can increase your risk of getting cervical cancer. Decide what's next1. Do you understand the options available to you? 2. Are you clear about which benefits and side effects matter most to you? 3. Do you have enough support and advice from others to make a choice? Certainty1. How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps. Credits
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version. Last Revised: December 28, 2010 Author: Healthwise Staff Medical Review: Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology eMedicineHealth Medical Reference from Healthwise
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions. To learn more visit Healthwise.org © 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. |
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