For women, Pap smears are an essential preventive screening test to stay on top of your health. They allow doctors to see abnormal cell changes before they turn into something more serious, like cancer.
A normal Pap result means you don't need testing for another few years, but what if your test comes back abnormal? It doesn't necessarily mean you have cervical cancer.
If you're worried about the next step after receiving an abnormal Pap result, Dr. Inga Zilberstein and her team are here to help. As an experienced, board-certified OB/GYN, Dr. Zilberstein offers personalized medicine and gynecology care for women in the Upper East Side of Manhattan, New York.
The Pap smear is a preventive screening tool doctors use to look for changes in the cells in a woman's cervix. It's a simple test that Dr. Zilberstein performs during your well-woman exam.
An HPV test goes hand-in-hand with a Pap smear because HPV is one of the leading causes of cervical cell changes that lead to cancer. Both screenings have the potential to save lives because, through routine testing, they can identify changes before cancer develops.
Most women only need a Pap smear starting at age 21 unless symptoms warrant further investigation. From age 21 to 29, you should have a Pap test every three years, as long as the result is normal.
After 29, you should have a Pap smear every three years if you only have the Pap test or every five with a combined Pap and HPV test. You may stop having Pap tests after age 65 as long as you don't have any risk for cervical cancer and you’ve had negative tests in the past.
The Pap test itself is relatively painless, although some women experience mild to moderate cramping during this very quick procedure. Dr. Zilberstein uses a speculum to open your vaginal walls to examine your cervix and uses a small swab to collect cells from different areas. She then puts the swab in a tube and sends it to the lab for evaluation.
Understand that not every abnormal Pap smear means cancer; an atypical result implies that some of the cells in the cervix look different than your healthy cells.
There are several reasons you could receive an abnormal test result, including an HPV infection or uterine polyps. If your test result comes back with “atypical squamous cells of undetermined significance,” it simply means some of your cells look a little different without a clear reason why — it could be from an HPV infection or a yeast infection.
Some abnormal results are more concerning, even if they aren't cancer. If you have any of the following in your report, you may need more testing to determine the cause and the next steps in treatment:
If your test comes back with adenocarcinoma in situ or squamous cell carcinoma or adenocarcinoma, you may have precancerous or cancerous cells in your cervix. These results require immediate follow-up and treatment to prevent the cells from spreading. Early detection of cervical cancer — the point of a Pap smear — greatly improves your chances of treating it successfully.
When your Pap smear results come back from the lab, our team contacts you to let you know your results. If your test results are abnormal, we have you make a follow-up appointment so Dr. Zilberstein can discuss your latest results, review your previous test results, and determine the next steps in treatment.
You may need other testing or simply need a repeat Pap or HPV test in the next year.
For some abnormal results that warrant further investigation, Dr. Zilberstein conducts a colposcopy. During a colposcopy, she applies a vinegar solution to the cervix. She then uses a colposcope, which has a magnifying lens and a light, to examine the irregular cells more closely.
Dr. Zilberstein may take biopsies of the abnormal cells to obtain more definitive results. Biopsy may cause mild cramping and bleeding, which often resolves on the same day. Lab specialists examine the tissue samples to determine what treatment is necessary.
The good news is that in most cases, abnormal cells aren't cervical cancer – but they may be a sign you need treatment for HPV, another infection, or problems in the uterus. To discuss your next steps, call or text Inga Zilberstein, MD, at 830-254-5941 or request a consultation online.
