What do my smear results mean?

cervix cancer, cervical cancer, abnormal smear test result.When you’re at your Pap smear appointment, make sure you ask the questions that concern you.

These may include:

  • How long do I have to wait before the result comes back?
  • What do the results mean?
  • What happens if the result is abnormal?

In this article we’re going to look at the second 2 questions.  The lab your doctor’s office uses will determine how fast the result is process.

The Pap smear result.

The smear looks at the cells on the surface of the cervix.  These cells are sensitive to the female hormones (and the hormones in the contraceptive pill if you’re taking that), but also to viruses, bacteria and fungal infections.  These can affect the result.

Your result can include ‘non-results’ such as:

  • Insufficient sample’ which means that there were too few cells taken for the pathologist to see under the microscope.
  • Contaminated sample’ means that there may be other cells in the sample that make looking at the cervical cells impossible.  This often happens if a woman has a heavy vaginal discharge, has had sex within 24 hours before the smear, or has a vaginal infection.

In this case you will have to have the smear repeated and it’s usually recommended that you wait for about 3 months before this is done.

Otherwise, results tell the practitioner about the health of the cervix and whether Human Papilloma Virus is present. This is the virus that causes genital warts.  There are several different types of virus and some types can cause cervical cancer.

cervix cancer, cervical cancer, abnormal smear test result.Changes in the cells at the surface of the cervix go through a series of changes before they become cancerous and this is what the Pap smear looks at.  In the UK and US these changes are given different names.  They mean the same thing but we’ll give both names below, with the US terminology given in brackets and in italics.

You may also see or hear the term ‘dyskariosis’ (say ‘diss-carry-ose-iss’) or ‘dysplasia’ (say ‘diss-play’zia’) which mean ‘abnormal cell changes’.

  1. Normal, or negative – no abnormal cells detected at this time (**but see below).
  2. Borderline changes (ASCUS or AGUS) mean that the cells have changes that may be due to the Human Papilloma Virus and may or may not become cancerous if they are not treated or checked regularly.
  3. Mild changes or CIN1 (Low grade dysplasia/LSIL) mean that there are some pre-cancerous changes present.
  4. Moderate or severe changes or CIN2/CIN3 (High grade dysplasia/HSIL) mean that there are cell changes that are more advanced but note they are still not cancerous.
  5. Carcinoma in situ (term is the same in the UK and US) means the cell changes are likely to be cancerous.  This is not a definite diagnosis – further testing with colposcopy is needed.
  6. Glandular neoplasia (atypical glandular cells) mean that there are cells that cells in the upper part of the cervical canal or the womb that might become cancerous.  Cancer needs then to be excluded by colposcopy and/or other tests  – see the next article in this section What happens after an abnormal Pap smear result?’

** It’s important to remember that any medical test can give a false positive or a false negative result.

This means that a test result can look as if it’s abnormal but, for some reason, it’s actually fine.  A further test will confirm this.

A false negative result means that it looks normal but is in fact abnormal.

What can you do about a false negative Pap smear result?

  • Attending for regular smear tests gives you the best chance of having the health of your cervix checked.  Remember that the test doesn’t look for cancer but the changes that can lead to cancer.
  • Discuss any symptoms that worry you with your doctor.  Cervical cancer and pre-cancer changes symptoms are rare unless the cancer is more advanced – that’s why screening is so important.

The symptoms of cervical cancer include:

  • Abnormal bleeding, for example bleeding after sex or between your periods or after the menopause; after a pelvic exam or after douching.  This can include spotting as well as heavier bleeding.
  • Having menstrual periods that are heavier or longer than they normally are for you.
  • An unusual vaginal discharge between your periods or after the menopause.  The discharge may or not be blood stained.
  • Pain during intercourse.

These symptoms can be caused by conditions other than cervical cancer or pre-cancer.

For more information, look at this article from Medline Plus.

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