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HSR Research > Atypical Pap smear

Atypical Pap smear

An atypical Pap smear shouldn’t be a cause of significant concern for a woman until additional diagnostic procedures, like colposcopy and biopsy, are completed. Since the main purpose of a Pap smear is to detect precancerous and cancerous conditions of the cervix some women think that an atypical Pap smear means they have cancer. However, it is not always true. Atypical changes may appear on the cervix due to various factors, and in most cases it is not a serious health problem. 

Cytological analysis of cervical cells which is known as a Pap smear is an effective way to prevent the development of cervical cancer. It gives the opportunity to reveal and treat dangerous changes in the cervical mucosa that may develop in cancer. At the same time, cytological analysis shows benign cellular changes, i.e., which are not linked with carcinogenesis. Cells may undergo changes if they are affected by viruses or bacteria. An atypical Pap smear could also result from cervical injuries, irritation or exposure to some chemicals. 

Today, there are different classification systems used to describe cervical abnormalities. The most internationally accepted system is the Bethesda system. This system includes the following categories of atypical Pap smear: ASCUS (atypical squamous cells of undetermined significance); AGUS (atypical glandular cells of undetermined significance); ASCH (atypical squamous cells of undetermined significance, a high-grade squamous intraepithelial lesion is not excluded as a possibility); LSIL (low-grade squamous intraepithelial lesions); and HSIL (high-grade squamous intraepithelial lesions). 

In many cases an atypical Pap smear means that the examined cells are not normal, but definitive diagnosis cannot be made. When it concerns the cells from the surface of the cervix, the result of a Pap smear is ASUS. If undetermined atypia was detected in the cells from the cervical canal, the result is AGUS. If cells have atypical changes and the doctor suspects the presence of precancerous lesions then the Pap smear is classified as ASCH which requires subsequent realization of additional tests to better evaluate cellular changes. 

Atypical Pap smear categories LSIL and HSIL are actually suggestive of precancerous lesions on the cervix and show the risk level for the development of cancer. In women with low grade lesions (LSIL) the risk is not very high and in most of such cases the lesions regress without treatment. If a low-grade lesion persists for several months or years and there is no improvement in this condition, it can be treated with a simple and not so invasive surgical procedure. 

High grade cervical lesions (HSIL) are very likely to progress into cancer. However, even in these cases there is time to realize an effective treatment since cervical cancer develops very slowly. The treatment of these lesions is more complicated than in a case of LSIL and there is also a risk of recurrence. If a woman receives an atypical Pap smear result and it is confirmed by colposcopy and biopsy that she has high grade cervical lesions, she should follow all recommendations of health care providers and not postpone the treatment of the disease.

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Cervical Dysplasia
Genital Warts
Plantar Warts
Genital Herpes
Oral Herpes
Other Conditions

Dr. Joe Glickman, Jr., M.D.

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