Pap Smear (Abnormal)

Pap smears are used primarily to detect cancer of the uterine cervix or precancerous conditions - Abnormalities of the cervix that may lead to cancer. Since its introduction in the early 1940's, the Pap smear is credited with saving tens of thousands of women's lives and decreasing deaths from cervical cancer by more than 70%. The key is early detection made possible by microscopic examination of specially treated sample of cervical cells. Every woman should have an annual Pap smear as part of a complete pelvic examination beginning when she becomes sexually active or reaches 18 years of age and continuing for the rest of her life. Pap smears consist of cells removed from the cervix which are specially prepared for microscopic examination. The cells are removed by a gynecologist or other health care provider by brushing or scraping the cervix during a pelvic examination. The removed cells are evenly spread on one or more glass slides. Each slide typically contains hundreds of thousand of cells. All Pap smears should be sent to an accredited laboratory to be stained, examined under a microscope, and interpreted.

If the Pap smear from your cervix (the lower part of your womb) has shown some slight Abnormal changes, the following changes might have occurred.

ASCUS
ASCUS (pronounced "ask-us") stands for a typical squamous cells of undetermined significance. These changes in the squamous cells of your cervix mean that the cells on your Pap smear were slightly Abnormal. ASCUS may be caused by a vaginal infection or an infection with a virus called HPV (human papillomavirus, or wart virus). Your doctor will talk with you about the options of looking at your cervix with a microscope (colposcopy) or repeating your Pap smear every 6 months for 2 years.

AGUS
AGUS stands for a typical glandular cells of undetermined significance. These changes in the cells of your cervix mean that these cells were slightly Abnormal on your Pap smear. AGUS can occur with infections or with a change in the cells on the surface of your cervix or in the canal of your cervix. Your doctor will tell you how the Abnormal results on your Pap smear, needs to be evaluated. Your doctor may recommend repeat Pap smears or colposcopy.

LSIL
LSIL stands for low-grade squamous intraepithelial lesion. This is a common condition of the cells of the cervix and often occurs when the HPV wart virus is present. These changes in the cervix can be present even if you and your sexual partner are monogamous and have never had visible warts. Changes due to LSIL often get better with time. Your doctor will talk with you about whether you need to have Pap smears every 6 months for 2 years or whether you should have colposcopy.

INFLAMMATION
If inflammation is present in the cells on the Pap smear, it means that some white blood cells were seen on your Pap smear. Inflammation of the cervix is very common and usually does not mean that there is a problem. If the Pap smear showed that the inflammation is severe, your doctor may want to find the cause, such as an infection. You may also need to have another Pap smear in 6 months to see if the inflammation has gone.

HYPERKERATOSIS
Hyperkeratosis is a finding of dried skin cells on your Pap smear. This change in the cells of the cervix often occurs from using a cervical cap or diaphragm or from having a cervical infection. Hyperkeratosis rarely needs any more evaluation than a repeat Pap smear in 6 months. If the hyperkeratosis is still present on the repeat Pap smear, your doctor may want to repeat your Pap smear in another 6 months or perform colposcopy.
Please be sure that you let your doctor's office know if you move or change your phone number so that you can be contacted with the results of your Pap smears or to arrange any other follow-up tests you

Primary Prevention
The main risk factors for cervical cancer includes first intercourse at early age, greater number of sexual partners, increasing age, infection with human papilloma virus (HPV), smoking and low socioeconomic status. The relationship between cervical cancer and other possible risk factors such as oral contraceptive use and nutritional deficiencies (folate, vitamin A and vitamin C) is presently unclear. Some reports suggest a familial predisposition to cervical cancer, although the etiology of this disease is likely multifactorial with both genetic and environmental influences. The primary prevention of cervical cancer is therefore closely linked to ongoing public health initiatives targeting behaviour change of the population, particularly in the areas of smoking cessation and safer sex practices. 

Secondary Prevention
Early detection using the Pap smear remains the best currently available method of reducing the incidence and mortality of cervical cancer. Annual screening is recommended with the Pap smear after initiation of sexual activity or at age 18. If an organized screening program is in place with appropriate quality control measures and information systems, the screening frequency may be reduced (for women with two previous normal smears) to every 3 years until age 69.

Strong risk factors for cervical cancer and its precursors have been identified and include: early age at first intercourse (16 years or younger), a history of multiple sexual partners, a history of genital human papillomavirus (HPV) infection or other sexually transmitted disease, the presence of other genital tract neoplasia, and prior squamous intraepithelial lesion (SIL). Many of these factors appear to be surrogate markers for HPV exposure and infection. Additional risk factors include active or passive smoking, a current or past sexual partner with risk factors for sexually transmitted disease, immunodeficiency or HIV positivity, and poor nutrition.

The diagnosis and interpretation of an Abnormal pap smear is done by your doctor.

A wholesome diet including all essential nutrients is the key to good health.

Avoid smoking, even passive smoking as far as possible. Regular contraceptive usage has been shown to be a risk factor resulting in an Abnormal pap smears.

Any disease can be combated with appositive frame of mind. Learn to cultivate a positive attitude. Relax and reduce stress by meditation and prayer.