A pap test is done to identify abnormal cell changes on the cervix. An abnormal result indicates that cells on the cervix have changed, but only a small percentage of these changes are worrisome. Abnormal results are divided into the following categories:
- ASC - ASC stands for atypical squamous cells which are the cells that form the surface of the cervix. ASC is further divided into two categories.
- ASC-US means atypical squamous cells of undetermined significance. This basically means that some of the cells from the pap are not typical. HPV (see information below) testing is sometimes done when an ASC-US pap is found. If HPV testing is positive, further testing should be done (colposcopy). If HPV testing is negative, a repeat pap can usually be done in six months to a year.
- ASC-H means atypical squamous cells, cannot rule out a high grade lesion. If this result is found, further testing should be done (colposcopy).
- AGC - AGC stands for atypical glandular cells. Glandular cells produce mucous and are located in the canal of the cervix or in the uterus. If this result is found, further testing should be done (colposcopy).
- LSIL - LSIL stands for low grade squamous intraepithelial lesion. This means there are early changes in the size and shape of the cells. These changes are usually associated with HPV (see information below). If this result is found, further testing should be done (colposcopy).
- HSIL - HSIL stands for high grade squamous intraepithelial lesion. This means that the cells are very different from normal cells. If this is found, further testing should be done (colposcopy).
- COLPOSCOPY - A colposcopy is performed to help find the reason for an abnormal pap. A colposcope is an instrument that shines light on the cervix and magnifies the view, like a microscope. If abnormal areas of tissue are noted during the exam, biopsies may be performed. This involves removing small samples of tissue. These samples are then sent to a pathologist (tissue doctor) for examination. The biopsy results dictate whether any treatment needs to be done.
- HPV - There are many different sub-types of the human papillomavirus. Some of these strains cause pap test changes as listed above, others cause external genital skin warts. Many times, abnormal pap results can occur with no history of genital warts.