Abnormal Pap Test

SO, YOU HAVE AN ABNORMAL PAP TEST?

Very few experiences can be as frightening as receiving an abnormal pap smear report. Although cervical cancer is the first thing that 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 TEST?

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

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CLASSIFICATION OF PAP TESTS

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:

Findings in individual Groups

Significance

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Group 1 – No evidence of abnormal cells Normal Click here
Group 2 – Atypical cells; No evidence of Malignancy Probably from Infections or erosions

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Group 3 – Cells suspicious of Malignancy Suspicious; merits repeat smear and if positive again – investigations like Colposcopy or Cone biopsy

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Group 4 – Few definitive malignant cells seen Positive. Further investigations a must. Colposcopy, Diagnostic Curettage or Cone biopsy Click here
Group 5 – Large no of malignant cells seen Click here

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

THE NORMAL STRUCTURE OF THE CERVIX?

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The cervix is the opening of the uterus. The outside of the cervix and the vagina are covered by a layer of flat cells call squamous cells. When a Pap smear is taken some of these cells are scraped off to be examined under a microscope. The canal of the cervix is lined by tall column-like cells columnar cells.

Somewhere on the cervix the two cell types, squamous cells and columnar cells, meet at a place called the squamo-columnar junction. This junction may be on the outside of the cervix where it is easy to see or within the cervical canal where it may be difficult to see. The squamo-columnar junction is also called the transformation zone because the tall columnar cells are constantly being transformed into flat squamous cells.

It is in this transformation zone that abnormal growth or dysplasia develops.