 Medical
information
Abnormal Pap smear
A Pap smear is a screening test to check if abnormal changes have occurred
in cells of the cervix. The cervix is the lowest part of the
uterus and connects the uterus to the vagina. A Pap smear
is also called a cervical smear.
A layer of cells called squamous cells covers the outside surface of the cervix.
A layer called glandular cells lines the endocervical canal.
These two types of cells meet at the “transformation
zone”, which is usually on the outside of the cervix,
but may be just inside the endocervical canal.
When taking a Pap smear, the doctor gently scrapes cells from these areas. The cells are then smeared onto a microscope slide for examination in a pathology laboratory. The examination will determine whether the cells are normal or abnormal.
Treatment to remove abnormal cells on the cervix in most cases:
- results in the regrowth of healthy cells, and
- significantly reduces the risk of cervical cancer.
An abnormal Pap smear
Various changes in cells may be seen when a Pap smear is
examined. The important changes are called “dysplasia”.
Dysplasia is an abnormal change in the size and shape of cells.
Dysplasia is not cancer, but it might develop into cancer
over a long, but unpredictable, period of time if left untreated.
Most cervical cancers take years to develop. Dysplasia of
the cells on the surface of the cervix may be classified as
mild, moderate or severe.
Another term used to describe abnormal cervical cells is “cervical intraepithelial neoplasia” or CIN. Intraepithelial means “within the tissue” and “neoplasia” means new growth of (abnormal) cells. CIN-1 is mild dysplasia, CIN-2 is moderate dysplasia, and CIN-3 is severe dysplasia.
In addition to CIN changes, other abnormalities are commonly seen. They often need follow-up but do not necessarily mean that precancerous changes are developing.
Treatments for dysplasia
If the results of colposcopy and biopsy indicate a high-grade abnormality (CIN-2 or CIN-3), the doctor will recommend treatment to remove the abnormal cells.
Treatment may also be recommended for persistent low-grade abnormalities.
Wire Loop Excision
Wire loop excision is also known as LEEP (loop electrosurgical excision procedure) or LLETZ (large loop excision of transformation zone). A semi-circular wire loop is used to remove the portion of the cervix that contains the precancerous changes.
Many doctors prefer wire loop excision to other methods because the removed tissue is not destroyed, and it can be sent to a pathology laboratory for examination.
Wire loop excision is often preferred when abnormal cells are present in the endocervical canal. Using wire loop excision, it is possible to:
- confirm whether abnormal cells have been completely removed, and
- determine the type of abnormality present
Recovery and care after treatment
For three to four weeks after any treatment to remove abnormal cervical tissue:
- avoid having sex to reduce the risk of infection
- use sanitary napkins rather than tampons
- if there is any bleeding or spotting, avoid baths, spas
and public swimming pools; shower instead.
Follow-up
After treatment for a high-grade abnormality (CIN-2 or CIN-3), have a Pap smear
every six months for the first year and then always yearly.
A colposcopy may be recommended.
The information above is reproduced from 'ABNORMAL PAP
SMEAR - a guide for Women', published by the Royal Australian
and New Zealand College of Obstetricians and Gynaecologists
and Mi-tec Medical Publishing. The complete pamphlet is available
from your doctor.
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