A pap smear is a test of cells from your cervix to screen for cervical cancer. A healthy, normal cervix has squamous cells on its surface and glandular cells at its opening. Abnormal cell types found in a pap smear include atypical squamous cells, squamous intraepithelial lesion, atypical glandular cells, and squamous carcinoma or adenocarcinoma cells. A result with abnormal cells does not mean that you have pre-cancerous changes or cervical cancer, but your gynecologist might want to perform additional tests.
Atypical Squamous Cells
Normal squamous cells are small, thin and flat. Atypical squamous cells have an abnormal appearance, but they are not necessarily pre-cancerous. They can be coded as ASC-US (atypical squamous cells, undetermined significance) or ASC-H (atypical squamous cells, high grade). ASC-US means that the cells look abnormal, but it is not clear that there is any risk of pre-cancerous changes. ASC-H indicates a higher risk that the cells are pre-cancerous. Your gynecologist might want to test you for human papillomavirus (HPV), which can cause cervical cancer. If you have HPV, your gynecologist will probably want to monitor you more closely. If you don't have HPV, then atypical squamous cells in your pap smear are not a cause for concern.
Atypical Glandular Cells
Normal glandular cells grow near the opening of your cervix and in your uterus. They produce cervical mucus. If your pap smear shows glandular cells with an unusual shape, they might or might not be cancerous and your gynecologist might want to perform additional tests to determine where the cells came from and if they are cancerous.
Squamous Intraepithelial Lesion
Squamous intraepithelial lesion indicates that there are squamous cells that look more abnormal than atypical squamous cells and which could signal that pre-cancerous changes are occurring in your cervix. The cells are graded according to the likelihood that they will become cancerous based on their shape, size and color. Low-grade squamous intraepithelial lesion (LSIL) refers to cells that might become cancerous many years later. LSIL cells are often found in women infected with HPV. High grade squamous intraepithelial lesion (HSIL) refers to cells that are severely abnormal with a stronger chance that they will develop into cancer cells.
Cancer Cells
When cervical cancer occurs on the flat lining of your cervix it is called squamous cancer. Cancer of the gland cells near the opening of the cervix is called adenocarcinoma. In either of these conditions the cells present in your pap smear are so abnormal that your gynecologist can be fairly sure that you have cervical cancer. Carcinoma in situ means that cancer cells are present only on the surface layer. Cervical intraepithelial neoplasia (CIN) means that the cancerous cells have spread beyond the surface, and the depth and seriousness of the spread is rated from 1 to 3. Invasive cervical occurs when the cancer spreads deep into the cervix or out into other organs.
