As board-certified women’s wellness experts who offer routine cervical cancer screenings and as-needed follow-up care at New Beginnings OB/GYN in Shenandoah, Texas, our team knows it can be concerning to receive abnormal Pap test results.
But, an abnormal Pap smear doesn’t necessarily indicate cervical cancer.
This January, in recognition of National Cervical Cancer Awareness Month, Dr. Rania Ibrahim and Dr. Christina Parmar are here to discuss the importance of having routine HPV and Pap smear testing — and explain what abnormal results typically mean.
Every year in the United States, about 14,000 women are diagnosed with invasive cervical cancer — and nearly 4,400 women lose their lives to the disease. While women’s health experts are working to improve these numbers, they’re far lower than they were in the 1970s, when invasive cervical cancer was a leading cause of cancer deaths among American women.
So, why did the cervical cancer death rate drop by more than 50% over the last 50 years?
It all comes down to preventive screenings: More women are having regular HPV and Pap smear testing than ever before, and in turn, far fewer women are dying from cervical cancer — and far more women are surviving it — than ever before, too.
Done during a routine pelvic exam, Pap smear testing can detect abnormal cervical cells before they become malignant or catch cancer cells early, in their most treatable stage.
HPV tests detect the high-risk strains of the human papillomavirus that can cause cell changes on the cervix. High-risk HPV causes about 90% of cervical cancer cases.
We conduct both tests in the same way, using a slender brush to gently swab a few cells from the tissues around your cervix or the lower part of your uterus that opens into your vagina. We check these cell samples under a microscope to look for HPV, cancer cells, and abnormal cell changes that can potentially become cancerous.
Cervical cancer screenings with a Pap smear test are generally recommended every three years for women between the ages of 21 and 65. In the absence of increased risk or prior abnormal results, you may opt to switch to the following schedule starting at the age of 30:
Despite the availability of a preventive vaccine, HPV infection remains common in young women — especially low-risk HPV strains. Because it usually clears on its own, however, HPV testing is most beneficial for women aged 30 and older.
Given that the stated purpose of a Pap test is to “detect and prevent cervical cancer,” it’s understandable that most women would worry about abnormal results. We’re here to ease your mind about what abnormal results mean.
Most abnormal Pap results aren’t evidence of cervical cancer. Instead, they indicate the presence of cervical cell changes that may lead to cancer without intervention. These abnormal changes are typically caused by a high-risk HPV infection — which is why most abnormal Pap results coincide with a positive HPV test, too.
Cervical cell changes are classified based on their degree of abnormality:
Low-grade cervical cell changes are minor and often return to normal on their own. This means they generally don’t require treatment—just “watchful waiting” in the form of more frequent Pap tests.
The main objective of having regular Pap and HPV testing, as recommended, is to catch cervical cell changes at this stage before they’re precancers or malignancies.
High-grade cervical cell changes still aren’t a cancerous malignancy, but they are more serious because they’re likely to advance into cervical cancer if they aren’t removed. High-grade cell changes are called cervical “precancers.”
Invasive cervical cancer accounts for the smallest number of abnormal Pap results. It’s more likely to occur in middle-aged and older women who have not been getting regular Pap tests to screen for cervical cancer.
Low-grade cervical cell changes typically require frequent Pap testing and watchful waiting, but high-grade changes require further investigation. This can include:
A diagnostic colposcopy is like a pelvic exam but with a special viewing instrument that magnifies high-resolution views of the cervix. This allows us to determine the nature and severity of cell changes with greater precision. We may also take a small tissue sample (biopsy) to check for cancer cells.
Once you receive your colposcopy results, you may need treatment to clear any abnormal cells. A loop electrosurgical excision procedure (LEEP) uses a slim wire loop with an electrical current to remove thin cervical tissue layers — and eliminate precancers.
Call or click online to book an appointment today at New Beginnings OB/GYN in Shenandoah, Texas, to learn more about abnormal Pap results or schedule a follow-up exam.