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SO, YOU HAVE AN ABNORMAL PAP TEST?
Very few experiences can be as frightening as
receiving an abnormal pap smear report. Although cervical cancer is the first thing
that comes to mind, most of the time an abnormal pap smear indicates a minor problem
with the cervix that may or may not need treatment.
WHAT IS THE PAP TEST?
During a pap smear
some cells are scraped off the
cervix, and prepared on a slide that is examined under a microscope. The purpose of
the Pap test is to detect changes that may lead to cervical cancer much before cancer
develops. Pre-cancer of the cervix is easily treated, and almost always prevents
cancer from developing.
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CLASSIFICATION OF PAP TESTS
There have been many classifications of pap tests,
leading to a great deal of confusion. It is much simpler to think of the pap smear as showing one of several things:
Findings
in individual Groups |
Significance |
Picture |
| Group 1 – No
evidence of abnormal cells |
Normal |
Click here |
| Group 2 – Atypical
cells; No evidence of Malignancy |
Probably from Infections
or erosions
|
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| Group 3 – Cells
suspicious of Malignancy |
Suspicious; merits repeat
smear and if positive again – investigations like Colposcopy or Cone biopsy
|
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| Group 4 – Few
definitive malignant cells seen |
Positive.
Further investigations a must. Colposcopy, Diagnostic Curettage or Cone
biopsy |
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| Group 5 – Large no
of malignant cells seen |
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No matter which classification system is being used, all
pap smear reports can be thought of as belonging to one of the above groups.
THE NORMAL STRUCTURE OF THE CERVIX?
Click here to see the picture
The cervix is the opening of the
uterus. The outside
of the cervix and the vagina are covered by a layer of flat cells call squamous cells.
When a Pap smear is taken some of these cells are scraped off to be examined under a
microscope. The canal of the cervix is lined by tall column-like cells columnar cells.
Somewhere on the cervix the two cell types, squamous
cells and columnar cells, meet at a place called the squamo-columnar junction. This
junction may be on the outside of the cervix where it is easy to see or within the
cervical canal where it may be difficult to see. The squamo-columnar junction is also
called the transformation zone because the tall columnar cells are constantly being
transformed into flat squamous cells.
It is in this transformation zone that abnormal growth
or dysplasia develops.
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