A Pap test, or Pap smear, is a test that checks for precancerous changes or cancer cells in the cervix. According to the American Cancer Society, cervical cancer is typically slow growing, so regular Pap tests can pick up any gradual cellular changes, resulting in abnormal Pap tests. Further examination after the test results can determine whether cervical cancer is present.
Significance
The National Cancer Institute estimates that in the United States in 2009, approximately 11,270 new diagnoses of invasive cervical cancer were made and 4,070 women died from the disease. The American Cancer Society says that carcinoma in situ, or non-invasive cervical cancer, is nearly four times as common than invasive cancer.
Types
If a Pap smear is abnormal, it is further classified into various categories that describe the findings, according to the American Academy of Family Physicians, or AAFP. ASC stands for atypical squamous cells, which means the cells on the surface of the cervix do not look like typical squamous cells; ASC-US means the atypical cells are of undetermined significance and there is no clear reason for the test result and ASC-H means there is a possibility of the abnormal cells being high-grade dysplasia, or precancerous. AGC means atypical glandular cells, and women with this test result have a higher risk of cervical cancer. There are two kinds of results that signify lesions; LSIL, or low-grade squamous intraepithelial lesions, which are changes in the cells usually related to the human papillomavirus, or HPV; and HSIL, high-grade squamous intraepithelial lesions, which are typically precancerous, says the AAFP.
Identification
Once an abnormal pap smear is diagnosed, further evaluation is needed to accurately assess the cervical changes. A procedure called a colposcopy is performed to get a better look at the abnormal cells. This involves using a machine called a colposcope, which is similar to a microscope, to look at the cervix. The cervix is usually coated with a vinegar solution, and under a special light with the colposcope, any abnormal areas will turn white, guiding the physician to areas that need to be biopsied.
Symptoms
The American Cancer Society says that many women with cervical precancers and early cervical cancers do not have symptoms; they usually appear when the cancer becomes invasive. Common symptoms include abnormal vaginal bleeding, bleeding after sexual intercourse, post-menopausal bleeding, unusual vaginal discharge and pain with intercourse. These symptoms can also be signs of other conditions, so an accurate examination is crucial for appropriate diagnosis.
Treatment
Treatment for cervical cancer depends on the stage and extent of the cancer, the age of the patient and the patient's general health. The three main types of treatment for cervical cancer, according to the National Cancer Institute, are surgery, radiation therapy and chemotherapy.
References
- National Cancer Institute: Cervical Cancer Home Page
- American Cancer Society: What are the key statistics for cervical cancer?
- American Cancer Society: How is cervical cancer diagnosed?
- National Cancer Institute: Cervical Cancer: Treatment Option Overview
- American Academy of Family Physicians: Abnormal Pap Smears
