Pap smears are a common screening test that can be used to detect changes in the cervix that may lead to cervical cancer. One of the main causes of cervical cancer is an infection with the human papillomavirus, also known as HPV. As a result, many women have a test performed to look for the presence of different strains of HPV during their Pap smear.
Interpretation
Although Pap smears and HPV testing is commonly used to screen for warning signs for cervical cancer, a positive HPV test and an abnormal Pap smear does not mean that the patient has cervical cancer or will ever contract it. According to the American Congress of Obstetricians and Gynecologists, an abnormal Pap smear simply means that abnormal cells were detected on the Pap smear. This test is often done along with HPV testing, which looks for the DNA from HPV, as this virus is a common cause of abnormal Pap smears.
Bethesda System
Abnormal results from a Pap smear are typically classified according to the Bethesda system. Some types of abnormal cervical cells are more serious than other varieties, Family Doctor explains. Two less-serious varieties are known as "atypical squamous cells-unknown significance" and "low-grade squamous intra-epithelial lesion." Squamous cells are the cells on the surface of the cervix and a low-grade lesion means that the cells are relatively normal in appearance. Abnormal glandular cells, which would come from inside the cervix or the uterus, are more serious. High-grade squamous intra-epithelial lesions are also dangerous because these cells have become very abnormal and have a high risk of becoming cancerous.
HPV Strains
Not all strains of HPV carry the same risk for cervical cancer, Lab Tests Online explains. Some HPV tests only look for the 14 different strains of HPV that have been linked with cervical cancer, whereas other tests will also identify other strains, known as low-risk strains, which are less likely to cause cervical cancer. Women who have a positive HPV test may receive an additional test that will look for the presence of strains 16 and 18, as these are the two strains of HPV that have the highest risk of leading to cancer.
Additional Testing
Women who have an abnormal Pap smear and also have a positive HPV test may need more testing, the Mayo Clinic explains. For many women, this will include an additional Pap smear six months later to see if the lesions have gotten better or worse. Women may also receive a colposcopy, in which a specially designed instrument is inserted into the vagina to yield a magnified view of any cervical lesions. Any unusual cervical tissue can also be examined using a biopsy.
Treatment
In the event that a patient needs treatment for lesions or growths on the cervix, there are a number of options. A loop electrosurgical excision procedure involves the use of a small piece of wire with an electrical current that can burn away any abnormal cervical tissue. A cone biopsy, on the other hand, removes a cone-shaped wedge of material for further analysis. Cervical lesions can also be frozen using cryotherapy or burned away with a laser. In severe cases, a woman may need to have her cervix and/or uterus removed.
