An abnormal pap smear indicates that the woman has cells of the cervix that are not normal. Pap smear screening aims to identify abnormal cell of the cervix PRIOR to the time that they develop into cervical cancer. Most women with an abnormal pap smear DO NOT have cancer, but nonetheless getting the diagnosis of an abnormal pap smear is an extremely stressful time. Regular pap smear testing is the key to preventing cervical cancer, but does not reduce the risk of women needing further investigation for pre-cancerous changes to the cervix.
Changes to cells of the cervix are caused by the Human Papilloma Virus (HPV). This is a sexually acquired infection that is VERY common in sexually active women. There are over 200 types of HPV and there a small number that are considered high-risk for the development of abnormal cells of the cervix. Most women will clear a HPV infection without issue, but it is the persistence of the HPV infection to the cells of the cervix that leads to the development of pre-cancers and eventually cervical cancer. It must be remembered that the time to develop cervical cancer is in the order of 10 years (of persistent infection) or more. Hence, regular pap smear screening is VERY important to prevent this from occurring.
Once a woman develops an abnormal pap smear and depending on its severity, the options are to repeat the pap smear (usually in 12 months) or to refer the woman to see a gynaecologist to have a colposcopy. A colposcopy is a minor procedure performed in the office using an instrument to have a magnified view of the cervix using some special solutions to identify the abnormal cells. Occasionally, a small biopsy of the cervix is required to confirm that the cells are abnormal is sent to the laboratory to be reviewed.
The majority of women will not require treatment and will just need either follow up with their general practitioner or have a repeat colposcopy with the gynaecologist. Occasionally, treatment is required. Treatment involves removing a small amount of the cervix, either by surgical excision or laser ablation to treat the abnormal cells. It must be remembered that only a VERY SMALL number of women will be diagnosed with a cervical cancer and MOST women will be CURED by this treatment for pre-cancer of the cervix.