Abnormal Pap Smear

The pathologist might feel that there was not enough of the transformation zone sampled to be able to reassure you fully.

In any case, it is unlikely to mean a cancerous or precancer finding. If you have several unsatisfactory smears, the pathologist may suggest referral to the hospital to see why this is happening.

How Common is it to Have an Abnormal Pap Smear Result?

Currently in the UK, 1-2% of women aged 25-35 years will have an abnormal smear. It is most common within this age group, being extremely rare before the age of 15 years and falling off to 0.5-1% after 40 years.

Does Having an Abnormal Smear Mean That I may get Cervical Cancer?

The degree of abnormality reported by the pathologist is important in answering this question and deciding the cancer potential of a smear.

The smear is graded as being mildly, moderately or severely abnormal. A single 'mildly abnormal' smear is unlikely to represent significant short-term risk and the underlying changes may well regress to normal.

Defining percentages of smears which, left untreated, will progress to cancer is difficult since when looking at populations we do treat abnormal smears, and even the sampling process, to see what is present, may alter the progress.

About 30-60% of untreated moderate or severely abnormal smears will progress to cancer over a period of about 10 years. Over the subsequent 10 years it is estimated that one-third of these cancers might become invasive with the potential for serious harm or death, if not treated.

Since the abnormal cells have been picked up on the smear test, further investigation and treatment can stop this progression. This is why the majority of cervical cancers occur in women who have not participated in the National Screening Programme.

What About a Mildly Abnormal Smear?

Changes on the cervix associated with a mildly abnormal smear often regress, and the smear becomes normal again. Rather than refer you to the hospital straight away, it is common to repeat the smear in a few months time.

If the mildly abnormal cells persist, further investigation is warranted to ensure that something more sinister is not being missed.

What is the Significance of 'Wart Virus' on the Smear?

About 2% of women will have evidence of the human papillomavirus (also known as the "wart virus infection" as some strains of HPV can cause genital warts) on their smear despite the absence of genital warts.

Some variants of HPV are known to cause precancer. Overall, only about 15% of women with HPV on their smear are at risk of developing precancer. Like the other mild changes, it is possible that the HPV changes may resolve without any further action.

Most doctors would suggest further investigation at the hospital if it persists on two smears.

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