What should I expect if my Pap smear is abnormal?

If a Pap smear is abnormal, the next step is usually colposcopy, which is nothing more than a microscopic examination of the cervix done in the office. While a Pap smear samples random cells, colposcopy allows the gynecologist to inspect the surface of the cervix under magnification so that the area where the abnormality is can be targeted and biopsied. The small sample of tissue removed is then sent to a pathologist, who will report one of the following:

Normal tissue: Frequently, the cervical cells are normal, which indicates that the cells reverted back to a normal growth pattern. Occasionally, abnormal cells are present, but are high up in the cervical canal, beyond the view of the colposcope, which is why a follow-up short interval Pap smear is always done.

HPV changes: Human papilloma virus (HPV) is responsible for dysplasia and cervical cancers. Sometimes, cellular changes indicate the presence of the virus, but there are still no actual precancerous cells.

• CIN I: Mild dysplasia or low-grade squamous intraepithelial lesions.
• CIN II: Moderate dysplasia or high-grade squamous intraepithelial lesions.
• CIN III: Severe dysplasia, or high-grade squamous intraepithelial lesions, also known as carcinoma in situ.

Invasive cancer: True cancer that has infiltrated surrounding tissue and has the ability to spread.