Dear Friends and Patients, As the COVID-19 scenario unfolds, we at WHSNT are putting extraordinary precautions in place to protect our patients. We continue to take all recommended CDC sterilization and disinfecting guidelines, as we always do. In light of the recent COVID-19 outbreak, we are also taking additional measures to ensure your health and safety. We have sinks and soap in every exam room and multiple hand sanitizer stations throughout the office for your use. We are asking that everyone come to your appointment alone, if at all possible. We understand some people need a driver or may be forced to bring a child given the school closures, but in order to minimize risk of exposure, we are asking that you please come to your visit alone. We also ask that you arrive on time to your appointment, rather than early, to avoid patients congregating in the waiting room. We will make every attempt to immediately escort you to your own exam room that has just been disinfected by our team. We are screening our patients on arrival for fever, chills, cough, congestion, breathing issues, and recent travel. If you are feeling the least bit under the weather, please call us to reschedule your appointment for a later date. Your health and safety are our top priority and minimizing the number of people you are in contact with is your best protection now. We take pride in our excellent sanitation practices, and will continue to go the extra mile as we navigate this together. We at WHSNT are essential workers and will continue to provide care during this time. We are putting every precaution in place to protect ourselves so we can continue to serve our patients and our community. This issue is rapidly evolving and we will keep you updated as we learn more. WHSNT supports the Centers for Disease Control and Prevention (CDC) patient care guidance issued on March 17 and the efforts of state and local authorities to combat the COVID-19 outbreak. Also, of critical importance are immediate efforts to assure access to essential health care, including urgent and emergent care provided by OB/GYNs, which can alleviate burdens on primary care clinics and emergency departments. Beginning Wednesday, 3/25/2020, the following change will be put in place in order to minimize the exposure of both the patients and staff while still providing the community with essential OB/GYN care. We will only see Gynecology patients with an urgent, emergent, or time sensitive problem and OB patients. All routine wellness/preventative visits will be cancelled. If you have medications that need to be refilled, or a problem that needs to be addressed sooner, please contact our office. We have Telehealth visits available and are seeing patients in the office that need care that cannot be provided remotely. As soon as the CDC announces it safe for routine office visits to resume, we will contact you to arrange WWE/preventative visit. With prayers for good health, WHSNT Management
Home  >  Gynecology  >  Oh no! My pap smear is abnormal!

Oh no! My pap smear is abnormal!

Posted on Monday, November 9th, 2015 at 11:03 pm    

Don’t panic.  A pap smear is a screening test for cervical cancer and pre-cancer.  The pap test is usually done in conjunction with an HPV test. There are many causes of abnormal pap smears, and most can be managed in the office.  Once your test comes back abnormal, your provider reviews the test results and decides on a plan of action.

What are the different types of abnormal pap test results?

  • Atypical squamous cells of undetermined significance (ASC-US)—ASC-US means that changes in the cervical cells have been found. The changes are almost always a sign of an HPV infection. The changes may also be a result of infection or inflammation. ASC-US is the most common abnormal Pap test result.
  • Low-grade squamous intraepithelial lesion (LSIL)—LSIL means that the cervical cells show changes that are mildly abnormal. LSIL usually is caused by an HPV infection that often goes away on its own.
  • High-grade squamous intraepithelial lesion (HSIL)—HSIL suggests more serious changes in the cervix than LSIL. It is more likely than LSIL to be associated with pre-cancer and cancer.
  • Atypical squamous cells, cannot exclude HSIL (ASC-H)—ASC-H means that changes in the cervical cells have been found that raise concern for the presence of HSIL.
  • Atypical glandular cells (AGC)—Glandular cells are another type of cell that make up the thin layer of tissue that covers the inner canal of the cervix. Glandular cells also are present inside the uterus. An AGC result means that changes have been found in glandular cells that raise concern for the presence of pre-cancer or cancer.

What testing is done after an abnormal result?

  • Colposcopy with or without cervical biopsy—Colposcopy is an in office exam of the cervix with a magnifying device. If an area of abnormal cells is seen, your health care provider may decide that a cervical biopsy is needed. For a biopsy, the health care provider removes a small sample of tissue and sends it to a lab for testing. The lab tests can determine whether abnormal cells are present and, if so, how severe.
  • Endocervical sampling – A small brush or other instrument is used to take a tissue sample from the cervical canal.
  • Endometrial sampling— In the case of an AGC result, a sample of the endometrium (the lining of the uterus) may be collected for study using an instrument which looks like a small straw.

What are the potential results of the biopsy?

  • Cervical intraepithelial lesion (CIN) is used to report cervical biopsy results. CIN is graded as 1, 2, or 3.
  • CIN 1 is used for mild (low-grade) changes in the cells that usually go away on their own without treatment.
  • CIN 2 is used for moderate changes.
  • CIN 3 is used for more severe (high-grade) changes.
  • Moderate and high-grade changes can progress to cancer. For this reason, they may be described as “pre-cancer,” and are usually treated.

How are abnormal cervical cells treated?

  • Loop electrosurgical excision procedure (LEEP)—A thin wire loop that carries an electric current is used to remove abnormal areas of the cervix. This procedure can be done in the office or in the operating room.
  • Conization—A cone-shaped piece of the cervix that contains the abnormal cells is removed. This procedure must be done in the operating room.

These procedures are usually curative.  Once complete, patients are asked to come in for a follow up visit two weeks after the procedure to review pathology results and to form a plan for future testing.

 

Information adapted from ACOG Patient Information FAQ 187

Dr. Robin P. Kindred

Dr. Robin P. Kindred

Dr. Kindred is passionate about women's health and is an advocate for her patients. She believes that women should be educated and empowered to make the best healthcare decisions for themselves and their families. She sees patients exclusively at our Mansfield office.

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