Pap Smear
Pap smear or Pap test is conducted as part of a woman's routine health examination, after the age of 21 years. It is not a diagnostic test but is a screening tool used to detect any abnormal cells in the cervix. The cervix is the lower part of the uterus that opens into the vagina.
Pap smears help in early detection of any serious medical conditions such as cervical cancer.
Abnormal Pap smear may indicate the presence of infection or abnormal cells called dysplasia. An abnormal Pap smear may not necessarily denote cancer. These results highlight the requirement of supplementary testing to identify and confirm an underlying problem.
Causes of Abnormal Pap Smear
An abnormal pap smear may indicate any of the following:
- An infection or an inflammation
- Herpes
- Trichomoniasis
- Dysplasia (abnormal cells that may be pre-cancerous)
- Recent sexual activity
- HPV (Human Papilloma Virus) infection; also called genital warts
Presentation
Usually, abnormal cells do not produce any symptoms. Moreover, even the presence of HPV in an abnormal Pap smear is asymptomatic. Therefore, a regular Pap smear is beneficial in the early detection of any abnormalities.
However, an abnormal Pap smear secondary to a sexually transmitted infection may induce the following symptoms:
- Abnormal discharge from the vagina, such as a change in the amount, color, odor, or texture.
- Abnormal sensations such as pain, burning or itching in the pelvic or genital area during urination or sex.
- Sores, lumps, blisters, rashes, or warts on or around the genitals.
Treatment
If a Pap smear result is abnormal, the next step is usually a colposcopy, where the cervix is examined under magnification to identify areas of concern. The doctor may also perform additional tests, such as an HPV test or a repeat Pap smear, to clarify the findings.
Depending on the patient’s age and the type of abnormal cells, treatment options may include:
- Cryosurgery - freezing and destroying abnormal cervical cells.
- Loop Electrosurgical Excision Procedure (LEEP) or Cone Biopsy - removing a small section of cervical tissue containing abnormal cells for evaluation and treatment.
Abnormal Pap Smear During Pregnancy
A Pap smear during pregnancy is safe and routinely performed when due. If the result shows abnormal or atypical cervical cells, your provider may recommend a colposcopy to take a closer look at the cervix. This procedure is also considered safe during pregnancy, though any biopsy is done cautiously and only when necessary.
In most cases, treatment for abnormal cervical cells is postponed until after delivery, since mild changes often resolve on their own once pregnancy hormones normalize postpartum. Your provider will monitor you closely throughout pregnancy and repeat testing after birth to ensure the cervix has returned to normal.
