HPV and Pap smears: What do these tests mean?

When a woman turns 21, it is recommended she see a gynecologist for her first Pap smear. This screening test assesses the cells on the cervix in an effort to identify any changes from HPV. The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are over 100 different strands of HPV, and most people are infected with HPV at some point during their lifetime. Some strands are considered “low-risk” and are more associated with genital warts. Other HPV types are considered “high-risk” and are associated with the development of cervical cancer, such as HPV strands 16 and 18, which are known to cause 70% of all cervical cancers.

A Pap smear is an evaluation of abnormal changes to the cells that make up the cervix. A normal Pap smear warrants no further evaluation, and the patient may repeat their next visit. A result of “ASCUS” (atypical squamous cells of undetermined significance) is the most common Pap smear results, and indicates some changes have been found to the cervical cells and can represent benign inflammatory response to infection or trauma. The result, “LSIL” indicates mildly abnormal changes to the cervical cells and is usually caused by the HPV virus and resolves on its own. The result “HSIL” reveals more serious changes of the cervical tissue than LSIL and is usually caused by an HPV infection and may require closer monitoring or treatment. “ASC-H” result can be interpreted as changes to the cervix have been detected, and HSIL cannot be ruled out. “ASC-G” indicates atypical glandular cells have been detected. Glandular cells cover the inside of the cervical canal and the lining of the uterus, and this Pap smear result may warrant further investigation. In addition to the Pap result, women who are over 30 years old will also get tested for high-risk strands of HPV, which either comes back as positive or negative. The combination of these two screening tests helps guide your provider in their future cervical cancer screening and treatment plans. It is important to stay up to date on your Pap smears and also give your provider as much information as you can on past abnormal results in order to ensure the highest quality of care.

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