Jefferson University Hospitals

Frequently Asked Questions

Discovering cervical abnormalities early through regular pap smears has been shown to significantly decrease the chance of developing cervical cancer. The growing number of women who get yearly pap smears today accounts for a significant drop in cervical cancer in the United States over the last 25 years. With early detection, precancerous changes in the cervix can usually be treated before they develop into cancer.

Who needs a pap smear?

Getting an annual pap smear is the best prevention for women against cervical cancer. The American Cancer Society recommends that women get a pap smear three years after they become sexually active or when they reach the age of 21, whichever comes first. This simple diagnostic procedure involves the removal of a tiny sample of cells from the opening of the cervix for laboratory testing. Pap smears are typically done during an annual gynecological check-up or routine physical.

Pap tests may detect abnormal cell changes long before they turn into cancer. In rare cases, a cervical abnormality may be missed on a pap smear. For this reason, all women should be alert to the possible symptoms of cervical cancer, which include persistent bleeding and bleeding after intercourse. If you have these symptoms, call your doctor, even if your last pap smear was normal.

What does an abnormal pap smear mean?

An abnormal result indicates that the cells on the outer layer of the cervix have changed in an unusual way. This does NOT mean you have cancer. Precancerous cell changes are 10 to 20 times more frequent than true cervical cancer. Sometimes, though, these unusual cells develop into preinvasive or precancerous lesions called “dysplasias” (dis-play-shas). If the dysplasia is severe, your physician will recommend removing the cells. Untreated, dysplasia can develop into cervical cancer.

An abnormal pap smear may also indicate the presence of the human papilloma virus (HPV), a common sexually transmitted disease also known as genital warts. Once a woman has been diagnosed with HPV, she needs to get pap tests more regularly because HPV is associated with the development of dysplasia.

Other times, abnormal pap smears are caused by infections that can be treated with medication.

How do I find out if the abnormal pap smear is linked to cancer?

If your pap smear shows an abnormality, your physician may suggest you have another diagnostic test called a colposcopy (col-pas-co-pee). This test provides a more specific and reliable indication of precancer or HPV infection than the pap smear. In a colposcopy, the physician applies a mild, vinegar solution to the cervix making any abnormal cells more visible. Using a binocular magnification device called a colposcope, the physician looks for abnormalities on your cervix and takes biopsies (small samples of tissues) from the most abnormal area. These samples are then sent to the laboratory for examination.

How are serious cervical abnormalities treated?

If you are diagnosed with moderate or severe dysplasia, you might need to have an additional biopsy performed after a colposcopy to rule out cancer and to remove additional abnormal cells. Your physician may perform either a cone biopsy or LEEP (loop electrocautery excision) procedure, depending on which is more appropriate in your case.

The cone biopsy is performed in a surgical outpatient unit under general anesthesia. The physician removes a cone-shape piece of the cervix with a scalpel. The LEEP procedure is performed under local anesthesia and employs a wire loop supplied with an electrical current to remove the tissue. Both diagnostic techniques are also used to treat some precancers that are restricted to the lower portion of the cervix.

If your physician detects a lesion elsewhere on the cervix, laser surgery may be recommended. Here, a beam of light is directed on the abnormal area and the heat kills the cells.

What happens if I don’t seek treatment for an abnormal pap smear?

Precancer is a warning that you are at risk of developing cancer. Therefore, if your pap test suggests a precancerous change in the cervix, it is in your best interest to seek further evaluation as soon as possible. Close, careful monitoring through pap smears and colposcopy is essential in preventing precancerous lesions from progressing to invasive cancer.

Invasive cervical cancer is treatable through radiation and/or hysterectomy. However, these treatments are both more complicated and more prolonged than the treatments for precancers described above. Cure rates are also lower, depending on the extent of the cancer.

If you detect and eliminate precancerous lesions promptly, your chances for a cure are excellent. From 90-95 percent of women treated by cone biopsy, the LEEP procedure, and laser are cured. Five percent of patients need retreatment.

Can I prevent cervical abnormalities?

You can reduce your risk of cervical cancer and other precancerous abnormalities by getting routine pap smears and protecting yourself against the HPV virus. Limiting your sexual partners and using condoms will reduce, but not eliminate your risk of HPV. If you smoke, giving up cigarettes will also cut your chances of cervical cancer.

What are clinical trials?

When laboratory research shows that a new treatment method has promise, patients with cancer have the opportunity to receive the treatment in clinical trials or protocols.

By participating in a clinical trial you may have the first chance to benefit from improved treatment methods and the opportunity to make an important contribution to medical science.

To find out more about current clinical trials that you may be able to participate in, ask your doctor or call 215-955-1661 or 1-800-JEFF-NOW.