What are Abnormal Pap Smear Cells?

When a woman visits a gynecologist for a routine Pap smear, she may be asked to return for a follow-up test if abnormal Pap smear cells are detected. This indicates the presence of abnormal squamous cells, but it does not necessarily mean that cervical cancer is imminent or even probable. Abnormal squamous cells can be detected all the time, and the diagnosis only means that cell changes have been found. Further testing is suggested, however, to rule out precancerous changes in the cells.

A Pap smear is a routine test given to a woman in which the wall of the cervix is scraped to remove cells which are then analyzed. Abnormal Pap smear cells in the cervical wall are found frequently, but they can mean the possibility of precancerous development. If a woman is called back to the doctor for a follow-up visit, a closer look is given to those abnormal cells.

Changes in the cells of the cervix are routine, but abnormal Pap smear cells must be analyzed closely to determine if there is the potential for cervical cancer. Cervical dysplasia is the term applied to the presence of these abnormal cells, and while dysplasia alone causes no health problems, it can develop over a period of years into cervical cancer. Routine Pap smears can detect this condition long before it turns into cervical cancer.

Abnormal Pap smear cells are graded according to a widely-used system known as the Bethesda System, first used in 1988. The abnormal cells are categorized from those least likely to turn into cancer to actual cancer cells. They are atypical squamous cells of undetermined significance (ASCUS); squamous intraepithelial lesions, either low-grade or high-grade (LSIL or HSIL); atypical squamous cells, cannot rule out HSIL (ASCH); atypical glandular cells (AGC); and adenocarcinoma in situ (AIS). All require further testing, but most do not turn out to be cancer.

A diagnosis of cervical cancer is far from a death sentence. Cervical cancer that is detected early can usually be treated on an outpatient basis and may not even require advanced treatments like chemotherapy. This is why Pap smears are recommended for every woman at the age of 21 and then subsequently every year. If a woman has had normal results for three consecutive years, she can usually be screened every three years from that point unless abnormal Pap smear cells are found.

In most known cases of cervical cancer, the disease is caused by the human papillomavirus (HPV). HPV is a sexually-transmitted disease which causes infections that usually last less than two years and most infections go away without treatment. There are over 100 strains of HPV, but only types 16 and 18 have been linked to cervical cancer.