Cancer of the cervix (a preventable cancer) still affects women in Anguilla and, because of this, women are encouraged to have a Pap test to help prevent cancer of the cervix from developing. Many individuals are often confused when their doctor tells them they have an abnormal Pap test. An abnormal Pap test does not mean you have cancer of the cervix. Detecting and treating an abnormal Pap test is an effective way to prevent cancer of the cervix from developing.
What is an abnormal Pap test?
A Pap test, or Pap smear, is part of a woman’s routine physical exam. It is the best way to prevent cervical cancer because it can find cells on the cervix that could turn into cancer. If these cells are treated effectively, cancer of the cervix can be prevented.
When your doctor says that your Pap test was “abnormal” it means that the test found some cells in your cervix that do not look normal. It does not mean that you have cancer. In fact, the chances that you have cancer are very small.
What causes an abnormal Pap test?
Most of the time, abnormal cell changes in the cervix are caused by certain types of human papillomavirus (or HPV). HPV is a very common infection. Usually these cell changes go away on their own. Certain types of HPV have been linked to cervical cancer. That is why it is important for women to have regular Pap tests. It usually takes many years for cell changes in the cervix to turn into cancer.
Sometimes cell changes in the cervix are due to other types of infection such as infections caused by bacteria or yeast. These types of cell changes can be treated. In women who have been through menopause, a Pap test may find cell changes that are just the result of getting older.
What increases your risk for an abnormal Pap test?
High-risk sex raises your chances of getting HPV and having an abnormal Pap test. High-risk sex includes having sex without condoms and having more than one sex partner (or having a sex partner who has other partners).
HPV can stay in your body for many years without your knowing it. So even if you now have just one partner and practice safe sex, you could still have an abnormal Pap test if you were exposed to HPV in the past.
Smoking or having an impaired immune system also may raise your chances of having cell changes in your cervix.
You can have an abnormal Pap test even if you do not have these risk factors.
Do abnormal cell changes cause symptoms?
Many individuals having an abnormal Pap test do not have any symptoms.
The cell changes themselves do not cause symptoms. HPV, which causes most abnormal Pap tests, usually does not cause symptoms either. This is why regular Pap tests are so important.
If a different sexually transmitted infection is the cause of your abnormal Pap test, you may have symptoms including:
• A discharge from the vagina, that Is not normal for you, such as a change in the amount, colour, odour, or texture.
• Pain, burning, or itching in your pelvic or genital area when you urinate or have sex.
• Sores, lumps, blisters, rashes, or warts on or around your genitals.
What to do if you have an abnormal Pap test?
In most cases the results of a Pap test will be communicated to the woman. Your doctor should see you and explain to you that you have an abnormal Pap test. The next steps will vary depending on the individual’s history and examination of the patient. In some cases your doctor might request more tests to find out if you have an infection or to find out how severe the cell changes are. These tests may include the following:
• Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool. This can be done in the gynaecologist’s office.
• An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.
• Another Pap test in 4 to 6 months.
A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also takes a small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a biopsy.
Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.
Conclusion
Having an abnormal pap smear does not necessarily mean you have cancer of the cervix. In my experience, most cases of an abnormal pap smears do not have cancer but may have a pre-cancerous lesion or an infection. If you have an abnormal Pap test do not panic. Talk to your doctor who might refer you to a gynaecologist for further management. Having regular Pap tests and treating abnormal Pap tests can prevent cancer of the cervix.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
