Health Services

Pap Smears: When Yours is Abnormal

What does an abnormal Pap smear mean?
A Pap smear allows your healthcare provider to look at the cells from your cervix (the lower part of your womb) and see if there are any problems. An abnormal Pap smear means that the cells of your cervix have shown some abnormal changes. Some abnormal cells are more likely than others to be warning signs of cancer. Ask your healthcare provider which of the following changes you have.

ASC stands for atypical squamous cells. Squamous cells form the surface of your cervix. ASC is divided into two categories:

  • ASC-US means that although some of your cells are not normal, your healthcare provider may not know why the cells changed or what impact it will have on you. These changes are usually not serious and may be caused by a vaginal infection, cervical irritation, or infection with a virus called HPV (human papillomavirus). Your healthcare provider may want to do a follow-up examination such as a repeat Pap smear or HPV testing.
  • ASC-H means that some of your cells are not normal and there is a possibility that they may be precancerous. Your healthcare provider will probably want to perform a colposcopy, which will allow your doctor to more closely examine your cervix. (See below for more information on colposcopy.)

LSIL stands for low-grade squamous intraepithelial lesion. Low-grade means there are early changes in the size and shape of the cells. LSILs are often associated with the presence of HPV, which may cause genital warts. You can be infected with HPV even if you or your partner have never had visible warts. Your healthcare provider will probably perform a colposcopy, HPV testing or recommend a repeat Pap smear.

HSIL stands for high-grade squamous intraepithelial lesion. High-grade means the cells are very different from normal cells. These cells are usually precancerous and are more likely to lead to cervical cancer. Your healthcare provider will probably perform a colposcopy to localize and confirm the abnormality.

If inflammation is present in the cells on the Pap smear, it means that some white blood cells were seen on your Pap smear. Inflammation of the cervix is very common and usually does not mean there is a problem. If the Pap smear showed the inflammation is severe, your healthcare provider may want to find the cause, such as an infection. Your healthcare provider may also recommend a repeat Pap smear to see if the inflammation has gone.

What is a colposcopy?
A colposcopy is a procedure that allows your healthcare provider to closely examine abnormal cells on your cervix. Your healthcare provider may coat your cervix with a vinegar solution that causes abnormal areas to turn white. Then, your healthcare provider will examine these areas using a colposcope, an instrument like a microscope. A small piece of tissue may be removed for study in a laboratory. This is called a biopsy.

Revised 05/05