Answers about your abnormal Pap smear

Very few experiences can be as frightening as receiving a call that your pap smear came back abnormal.  Although cervical cancer is the first thing that may comes to mind, most of the time an abnormal pap smear indicates a minor problem with the cervix that may or may not need treatment. 

What is the Pap smear?

During a pap smear some cells are scraped or brushed off the cervix, and prepared on a slide that can be examined under a microscope.  The purpose of the Pap test is to detect changes that may lead to cervical cancer long before cancer develops.   Pre-cancer of the cervix is easily treated, and almost always prevents cancer from developing.

Classification of Pap smears

There have been many classifications of pap tests, leading to a great deal of confusion.  It is much simpler to think of the pap smear as showing one of several things:

	Normal, or a variation of normal, such as "irritation"
	Probably normal, but there are mild changes that you should keep an eye on or evaluate further (ASCUS)
	Pre-cancerous changes
	Invasive cancer

No matter which classification system is being used, all pap smear reports can be thought of as belonging to one of the above groups.

Years ago, pap smears were graded on a scale from 1 to 5, with 1 being normal and 5 being cancer.  There was little agreement between labs of what the numbers meant.   Although this classification system is obsolete, some labs unfortunately still use this reporting system. 

In order to understand how pap smears are classified, you first need to know a little more about the cervix.  [Next]