Reproductive Health Issues

Causes of Abnormal Pap Smear Results

November 21, 2018

Most women get their regularly scheduled Pap smears rather than look back. Should they receive regular test results, their gynecologist may not even call them. But what exactly does it mean when you get an abnormal Pap smear result? How can you decode the results your physician is reporting to you?

What Do All These Words on My Abnormal Pap Smear Report Mean?

ASCUS: This stands for Atypical Squamous Cells of Undetermined Significance.

This means that there are squamous cells which don’t look normal, but they’re not abnormal enough to be contemplated dysplasia.  ASCUS may be caused by an early HPV infection, or from aggravation from sex. No intervention is required, since the problem will fix itself. You need to find a Pap smear after six months just to determine that everything is back to normal.

SIL: This is just another common abnormal Pap smear result. It stands for squamous intraepithelial lesion. These are squamous cells that were changed in a way that indicates they may eventually become cancerous. Many instances, however, will resolve by themselves.

LSIL/CIN 1: Reputation for low grade squamous intraepithelial lesions (LSIL), this is almost always a sign that a woman was infected with HPV. It also suggests that the doctor reading the Pap smear or biopsy has observed signs that look like early-stage pre-cancer.  LSIL diagnoses are rather common, and frequently resolve by themselves without treatment.

In young girls, a follow-up Pap smear is suggested. For older women, the American College of Obstetrics and Gynecology (ACOG) guidelines suggest a colposcopy to find out the extent of harm. 

HSIL/CIN 2-3: High grade squamous intraepithelial lesions (HSIL) are more inclined to become cervical cancer than LSIL; but a number of these lesions still regress on their own.

Guidelines state that each girl who’s diagnosed with HSIL get a colposcopy. During the colposcopy procedure, lesions might be biopsied, or they may be treated by LEEP, conization, freezing (cryotherapy), or laser therapy. 

ASC-H: This stands for”atypical squamous cells, can’t exclude HSIL” and signifies that doctors are having trouble making a diagnosis. Follow-up by colposcopy is suggested.

AGC: Atypical glandular cells (AGC) refers to modifications to the cervix that don’t happen in the squamous epithelium. Instead, abnormal glandular cells were seen in the sample, which implies there may be cancer in the upper areas of the cervix or the uterus.  Follow-up can contain colposcopy, HPV testing, and sampling of the lining of both the uterus and cervix. Treatment, if needed, is more invasive than using squamous cell lesions.

Cancer: When you’re diagnosed with cervical cancer, it usually means that the harm to your own cervix is not any longer superficial. You will probably be delivered to an oncologist for further follow-up and treatment. 

For More Reading

What are the stages of cervical cancer and exactly what exactly do they mean?  Cervical Cancer includes five distinct classes in its staging system.  Learn about every one of those categories in-depth.

Your First Pap Smear. Frequent questions women have about Pap smears.

ASCUS Pap Smear Results.  A Pap smear may alert your physician about the presence of suspicious cells on your cervix which need additional treatment or testing.