Abnormal Pap Smears
Pap smear abnormalities are very common. The most common abnormality is termed ASCUS, which stands for Atypical Squamous Cells of Undetermined Significance. Over 90% of these are actually false positives, and there is no abnormality. The most direct way to evaluate this abnormality is with a procedure called colposcopy. This is a simple office procedure that obtains microscopic views of the cervix and vagina.
Other Pap smear abnormalities include low grade and high grade dysplasias. Dysplasia is an abnormal cell. With a low grade dysplasia your body’s immune system will usually sense that something is wrong and get rid of the abnormal cells and you don’t need any treatment except careful monitoring. A high grade dysplasia is best thought as a pre-cancerous condition. Left untreated 10-15% of these high grade dysplasias will eventually become cervical cancer. These high grade dysplasias can conservatively treated with a LEEP procedure.
These abnormalities are generally caused by HPV, or Human Papilloma Virus. HPV infections are essentially ubiquitous. Almost everyone has had a transient infection with HPV. There are over one hundred different types of HPV. Although some types are linked to genital warts and cervical cancer, other can cause plantar warts or no symptoms at all. HPV testing can aid in the diagnosis of certain Pap smear abnormalities.
A highly effective vaccine for HPV, Gardasil, is recommended for women age 9 – 26.