You go for your normally scheduled pap test, but this time things are different. You get your test results, and you see ABNORMAL.
You, along with 8% of Canada’s female population, are wondering the same thing. What does this mean?
In this blog post, we break down what you need to know about the Pap smear, the possible results, and what it means to have epithelial cell abnormality.
First, let’s break down what an epithelial cell is.
What is an Epithelial Cell?
Epithelial cells are found on the surface layers of the body such as the skin, respiratory tract, urinary tract, and organs. The cells create a barrier between the inside and outside of the body, protecting it from invaders like viruses, bacteria, and other pathogens.
Epithelial tissue is one of the four major tissue groups and can be found lining many parts of the digestive system, the epidermis, the oral cavity, many of the body’s glands, and the cervix.
There are three types of epithelial cells: squamous, cuboidal, and columnar. Squamous cells are what we commonly examine when it comes to Pap testing and cell abnormality. Squamous cells are found in the esophagus, mouth, and vagina, protecting the body against wear and abrasion.
What Is An Epithelial Cell Abnormality?
An Epithelial Cell Abnormality is when an epithelial cell has undergone abnormal cellular changes, which could indicate cancerous or pre-cancerous cells. When abnormal cells are found on the cervix, this is also known as cervical dysplasia.
Epithelial cell abnormality and cervical dysplasia are detected through a Pap test.
What is the Pap Test?
The Pap test or Pap smear was invented in the 1920s by a gynecologist named George Papanicolaou. While researching, Papanicolaou discovered certain cellular smears taken from the vagina and cervix and viewed under the microscope differed in epithelial cellular normality. His discovery revealed early detection of cancerous cells in women presenting without any current symptoms.
The Pap test has now become part of routine physical examination for individuals with female reproductive parts to detect and monitor the presence of precancerous or cancerous cells on the cervix that may progress into cervical cancer.
The test results from a Pap smear can go one of three ways: NORMAL, UNCLEAR, ABNORMAL.
- Normal: Indicates no cellular changes or precancerous activity was found.
- Unclear: Often warrants a repeat Pap test. This indicates that your cells could be mildly abnormal, due to a vaginal or sexually transmitted infection, changes in hormones, or poor test collection.
- Abnormal: An abnormal Pap test means that some level of cervical cell changes were found. It does not mean that you have cervical cancer but further testing is recommended.
Breaking down the Abnormal Pap Test Results
The Pap test is a screening test that reports different grades of abnormality. The following table displays the severity of these results from lowest to highest:
|Degree of Severity||Pap Test Result|
Abnormal Result Breakdown
Here is a breakdown of abnormal Pap test results:
- Atypical Squamous Cells of Undetermined Significance (ASC-US) The most common of all abnormal Pap test findings. ASC-US means the squamous cells of the cervix look abnormal. This is likely due to an HPV infection. Usually, the cells return to normal on their own, but your doctor will likely recommend monitoring to be safe.
- Atypical Glandular Cells (AGC) This type of result is unique from the others listed here as they relate to glandular cells instead of squamous cells. Cervical mucus and mucus in the uterus are produced by these glandular cells. An AGC result indicates that there are abnormalities in the cervix’s glandular cells and raises concerns about pre-cancerous or cancerous cells. Further testing and monitoring will be recommended.
- Low-grade Squamous Intraepithelial Lesions (LSIL) This indicates mild cervical dysplasia, abnormal tissue potentially signifying early stages of cancerous processes. These changes are likely due to an HPV infection. Often these changes return to normal over time but require monitoring. This could also be known as cervical intraepithelial neoplasia, or CIN 1.
- Atypical Squamous Cells (ASC-H) Atypical squamous cells are another form of cell abnormality that has a high possibility of being HSIL. Further testing must be completed to know for sure.
- High-grade Squamous Intraepithelial Lesions (HSIL) This result indicates moderate to severe dysplasia. An HPV infection is present and spreading, causing more serious changes. This is still not cancer, but it has a higher risk of progression into cancer if untreated. With adequate support and treatment, it may go back to normal findings. A CIN 2 or 3 classification would fit here.
- Adenocarcinoma In Situ (AIS) This finding indicates an advanced lesion was found with a high risk to develop into cancer without proper treatment. This is a stage where it is critical to prevent cervical cancer progression. A CIN 3 classification would fit here.
- Squamous Carcinoma: A positive screening for squamous carcinoma indicates cancer. Squamous cell cervical cancer makes up 80% of all cervical cancers. At this stage, precancerous cells have progressed to cancer and require further treatment of surgery, radiation, chemotherapy, or other immunotherapies. A diagnosis of squamous is quite rare. Women who receive regular Pap tests will catch cervical cell changes before cancer develops and are very unlikely to ever unknowingly reach this stage.
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What does Cervical Intraepithelial Lesion (CIN) mean?
The Pap test cannot tell the exact severity of cervical cellular changes. A cervical biopsy taken through colposcopy is needed to find out whether precancer or cancer is actually present. Cervical biopsy results are reported as Cervical Intraepithelial Lesion (CIN) on a grade of 1, 2, or 3.
- CIN 1: indicates mild, low-grade changes in the cells. CIN 1 often will go away on its own without treatment.
- CIN 2: is used for moderate cellular changes. This is a higher-risk for progression into a pre-cancerous stage.
- CIN 3: indicates more severe (high-grade) changes, with a higher likelihood to progress to cancer and may be classified as precancer.
Frequently Asked Questions:
What is an HPV test?
In individuals with abnormal Pap test or females above the age of 30, the Pap test may be combined with an HPV test. The HPV test screens for the presence of the HPV virus, which causes cervical cancer. HPV is very common and can be present without any signs of cervical abnormality. It is often tested to determine which strain of HPV you have contracted. Because some strains have a higher chance of progressing to cancer, knowing the specific strain and viral presence can help your doctor monitor your risk.
How often do I need to get a Pap test?
Pap smears have now been recommended for sexually active females between the ages 25-69 to be performed once every 3 years. If you have had an abnormal Pap your doctor will repeat your Pap every 6- 12 months until they are clear.
What should I do following an abnormal Pap?
Following an abnormal result, your primary healthcare provider will refer you for colposcopy. A colposcopy allows for closer examination of the cervix using a microscope. A cervical biopsy may also be taken for more accurate detection of cell types. Read more on what you can expect in a colposcopy appointment.
How are abnormal cervical cells treated?
Depending on the severity of cervical abnormality your doctor will recommend monitoring or treatment. Treatment usually includes an excisional and ablative treatment where cervical tissue is removed or destroyed. Loop electrosurgical excision procedure (LEEP) and Conization are the two most common excisional treatments. LEEP uses a thin wire loop that carries an electric current to remove abnormal cells. Conization removes a cone-shaped piece of the cervix that contains abnormal cells. Cryotherapy and laser are the two most common ablative treatments.
How can I naturally support my body to clear HPV?
A healthy diet and lifestyle are key to supporting your immune system eradicate the virus. Making lifestyle changes such as eating more fruits and vegetables, exercising daily, sleeping at least 7-8 hours a night, cutting out smoking, and excessive alcohol consumption. By making sustainable changes to support your overall health you will also help your immune system clear HPV.
We developed the Papillex supplement for this very reason, to boost your immune system and best prepare your body to regress those abnormal cells back to normal cervical cells. Papillex contains high-quality, fine-tuned ingredients hand-picked specifically to fight HPV infections.