Common Causes of Abnormal Pap Smear Results

What to Know About the Pap Smear Terminology You May See on Your Report

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Most women get their regularly scheduled Pap smears and never look back. If they receive normal test results, their gynecologist may not even call them. But what does it mean when you receive an abnormal Pap smear result? How can you decipher the results your doctor is reporting to you?

What Do These Words on My Abnormal Pap Smear Report Mean?

ASCUS: This stands for Atypical Squamous Cells of Undetermined Significance.

This means that there are squamous cells that don't look normal, but they're not abnormal enough to be considered dysplasia. ASCUS may be caused by an early HPV infection, or from irritation from sex. No intervention is required, as the issue will fix itself. You should get a Pap smear after six months just to determine that everything is back to normal.

SIL: This is another common abnormal Pap smear result. It stands for squamous intraepithelial lesion. These are squamous cells that have been changed in a way that suggests they may eventually become cancerous. Many cases, however, will resolve on their own.

LSIL/CIN 1: Standing for low grade squamous intraepithelial lesions (LSIL), this is almost always a sign that a woman has been infected with HPV. It also implies that the doctor reading the Pap smear or biopsy has seen signs that look like early-stage pre-cancer. LSIL diagnoses are relatively common, and often resolve on their own without treatment.

In young women, a follow-up Pap smear is recommended. For older women, the American College of Obstetrics and Gynecology (ACOG) guidelines suggest a colposcopy to determine the extent of damage. 

HSIL/CIN 2-3: High grade squamous intraepithelial lesions (HSIL) are more likely to become cervical cancer than LSIL; however, many of these lesions still regress on their own.

 Guidelines state that every woman who is diagnosed with HSIL get a colposcopy. During the colposcopy procedure, lesions may be biopsied, or they may be treated by LEEP, conization, freezing (cryotherapy), or laser therapy. 

ASC-H: This stands for "atypical squamous cells, cannot exclude HSIL" and means that doctors are having trouble making a diagnosis. Follow-up by colposcopy is recommended.

AGC: Atypical glandular cells (AGC) refers to changes to the cervix that do not occur in the squamous epithelium. Instead, abnormal glandular cells were seen in the sample, which suggests there may be cancer in the upper parts of the cervix or the uterus. Follow-up can include colposcopy, HPV testing, and sampling of the lining of both the cervix and uterus. Treatment, if necessary, is more invasive than with squamous cell lesions.

Cancer: If you have been diagnosed with cervical cancer, it means that the damage to your cervix is no longer superficial. You will probably be sent to an oncologist for further follow-up and treatment. 

For Further Reading

What are the stages of cervical cancer and what do they mean? Cervical Cancer has five different categories in its staging system. Learn about each of these categories in-depth.

Your First Pap Smear. Common questions women have about Pap smears.

ASCUS Pap Smear Results. A Pap smear may alert your doctor about the presence of suspicious cells on your cervix that need further testing or treatment.