Understanding Your Pap Test Results
Terms You May Find in
Your Pap Test Results
The two categories that appear on pap test results are "squamous" and "glandular". Squamous cells are found in the lower cervix, and are susceptible to becoming squamous cell carcinoma. The term "glandular" refers to mucus-producing glands of the upper cervix. These glandular cells are susceptible to becoming adenocarcinoma.
Normal vs. abnormal pap test results
When your pap test results come back from the lab, they may be negative, meaning there are no signs of cancer or precancer, or they may be abnormal, meaning there are cell changes present that may require further evaluation or treatment. There is a standard system that most labs use to describe pap test results, called the "Bethesda System". The Bethesda System provides a general guide for classifying cervical cell changes that makes it easier for your doctor to plan your treatment if necessary.
Cellular changes leading to cancer
This figure shows how squamous cells look under the microscope as they progress toward cancer. Compared to a normal cell (left), slightly abnormal cells (ASCUS, atypical squamous cells of undetermined significance) have larger, darker nuclei. A cell with some precancerous changes (LSIL, low-grade squamous intraepithelial lesions) appears misshapen. Cells with more severe changes (HSIL, high-grade squamous intraepithelial lesions) have large black nuclei where DNA rapidly reproduces. Cancerous cells are the most misshapen, and are very dark.
The Bethesda System
Using the Bethesda System, your pap test results will be categorized as one or more of the following:1,2
- Negative: No precancerous or cancerous cells found
- Squamous Cells:
- Atypical Squamous Cells (ASC): Some cells appear different than normal, but cannot be classified as precancerous
- Low-Grade Squamous Intraepithelial Lesion (LSIL): Mild precancerous changes may have been found in some cells
- High-Grade Squamous Intraepithelial Lesion (HSIL): Moderate to severe precancerous changes may have been found in some cells
- Squamous Cell Carcinoma: Cancerous cells are present
- Glandular Cells:
- Atypical Glandular Cells: There is an increased risk of precancer or cancerous cells
- Adenocarcinoma: Cancerous cells are present
It is important to remember that you should always consult with your doctor about your pap test results. Your doctor should be your trusted partner in your overall health care, and you should both agree on a planned course of treatment if one is necessary.
Next: understanding abnormal pap test results
References
1. NCI Bethesda System Terminology 2001. Available at http://bethesda2001.cancer.gov/terminology.html. Accessed 12/12/07
2. American College of Obstetricians and Gynecologists Pamphlet. Abnormal Pap Test Results. Washington DC; 2004.
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