A normal Pap smear shows healthy squamous cells (flat cells that look like fish scales) from the surface of the cervix. There are no signs of infection and no abnormal cells. Even if your Pap results are healthy, you should be tested every year. The tests screen for infectious agents that may be harmful if allowed to persist. Early detection of any infection will allow for better treatment and will help you maintain your health.
Abnormal Pap test results include:
ASCUS ~ Atypical squamous cells of undetermined significance
This diagnosis means that some of the cells on your Pap smear did not look entirely normal but did not meet diagnostic criteria for a lesion. Your doctor may either repeat your Pap smear, or perform a colposcopy (link to above). The lab may test your Pap smear specimen for HPV.
LSIL ~ Low-grade squamous intraepithelial lesion
This diagnosis means there are early changes in the size and shape of the cells. LSILs are often associated with HPV, which may also cause genital warts. These lesions, in women with intact immune systems, often resolve without intervention within 18 to 24 months. Low-grade lesions may also be called mild dysplasia, or CIN1. If it is your first abnormal Pap smear, your doctor will likely recommend a colposcopy (link to above).
HSIL ~ High-grade squamous intraepithelial lesion
This diagnosis means the cells appear very different from normal cells. These precancerous lesions are more severe than with LSIL, but involve cells on the surface of the cervix. They may also be called moderate or severe dysplasia, or CIN 2 or 3. The treatment for HSIL is to remove the abnormal tissue. This can be done in several ways. See the treatment section for more information.
Other conditions/special populations
A precancerous condition in which there are cancerous cells in the cervix that have not yet spread away from where they started or begun to grow into the deeper tissues of the cervix. The diagnosis is usually made by a biopsy or endocervical curettage (a gentle scraping of the cervical opening). The usual treatment is a cone biopsy (link to description). In some situations, your doctor may recommend a hysterectomy (surgical removal of the uterus).
A condition in which tissues in the vulva, or external part of the vagina, begin to grow in an unusual way, causing itching or burning; the development of lesions or warts; and bleeding. If untreated, it could turn into vaginal cancer. Generally, surgical removal of the abnormal tissue is the most effective treatment. This can be done by scalpel or by laser depending on the specifics of the condition.
Patients with compromised immune systems
Women with medical conditions that affect the immune system, like HIV or lupus; or who take immune-suppressing medications; or who are organ transplant recipients, are at greater risk for cervical dysplasia.