Abnormal Pap Smears
Diagnosis

Pap smears are an excellent way to detect dysplasia of the cervix, which is the most common site for dysplasia in women. The test is the most effective form of cancer prevention available to women. It has recently been adapted as a screening test for the anus, to detect anal dysplasias and cancer.

Once dysplasia has been detected on a pap smear, the genital area should be examined under magnification — a procedure known as colposcopy — to identify exactly where the dysplasia is located, followed by removal of the dysplasia if indicated. Anoscopy is using a scope to inspect the anus and lower rectum.

Sometimes, pap smears can be abnormal when there are no pre-cancerous conditions present. Some common types of abnormal pap smears are:

• Insufficient — There was not enough material to ensure that no abnormal cells were present.
• Obscuring — There was an infection or bleeding that limited the pathologist's ability to read the pap smear.
• Atypical — The cells don't look quite normal, but it is difficult to tell what exactly is going on.

For pap smears that show dysplasia, the next step is a colposcopy.

For other abnormal pap smears, the next step usually is to repeat the test. Sometimes, the practitioner will prescribe antibiotics or hormones, either oral or vaginal, before repeating the pap smear.

Reviewed by health care specialists at UCSF Medical Center.
Last updated February 8, 2012