Ask the Doc: An In-Depth Discussion About Abnormal Pap Smears

By Guest Editor on Apr 1, 2018

We talked to Dr. Alyssa Small Layne, with Las Vegas Minimally Invasive Surgery (LVMIS), to learn more about pap smears and cervical cancer. 

CareConnection: What is a Pap smear?

Dr. Alyssa Small Layne: A Pap smear is a test that collects a sample of cervical cells to look for abnormalities that may be cervical cancer and or precancer. 

CareConnection: When should I have/how often should I have a Pap smear?

Dr. Alyssa Small Layne: After age 21 women should have routine Pap smears every three to five years, depending on her age and the type of testing performed. If the Pap smear includes testing for the HPV virus, routine Pap smear can be performed every five years in women over age 30. Pap smears may need to happen sooner if the last Pap smear was abnormal and for patients with certain conditions. Most women can stop having routine Pap smears after age 65.

CareConnection: Should I do anything to prepare for the test?

Dr. Alyssa Small Layne: No special preparation is needed. Pap smears are performed routinely in the doctor's office

CareConnection: What happens if the Pap smear is positive?

Dr. Alyssa Small Layne: If a Pap smear is positive it is considered abnormal. Depending on how abnormal the result is, you may be a asked to come for a repeat Pap smear in six to 12 months, or your doctor may recommend a colposcopy. A colposcopy is procedure that uses a microscope device and different solutions to help magnify areas on the cervix that may be abnormal. Sometimes biopsies of the cervix are taken during colposcopy.

CareConnection: What classifies a Pap smear as abnormal? 

Dr. Alyssa Small Layne: Pap smears are classified as abnormal based on how the cells look when they are evaluated in the lab by a pathologist.

CareConnection: Does an abnormal Pap smear mean that I might have cancer? 

Dr. Alyssa Small Layne: An abnormal Pap smear does not necessarily mean that you have cancer. Things that irritate the vagina, such as infections, can also cause abnormal Pap smears. Abnormal changes to cervical cells caused by the HPV virus can lead to cervical cancer, however.  It is important to follow up after an abnormal Pap smear because procedures can be done to remove abnormal cervical cells and also to detect precancer and cancer early. 

CareConnection: What is HPV?

Dr. Alyssa Small Layne: HPV is the human Papanicolau virus. This virus has different strains and is known to cause genital warts, abnormal Pap smears and cervical cancer.

CareConnection: I had a hysterectomy. Do I still need a Pap smear?

Dr. Alyssa Small Layne: Supracervical hysterectomy is a procedure that leaves the cervix in place. Total hysterectomy removes the cervix with the rest of the uterus. If you still have a cervix after hysterectomy you will continue to need routine Pap smears. Most women with a history of normal Pap smears no longer need Pap smears after a hysterectomy.  Women with certain abnormal Pap smears, cervical cancer or precancer may need to continue Pap smears after a hysterectomy even if the cervix was removed. 

CareConnection: How can I reduce my chances of getting cervical cancer?

Dr. Alyssa Small Layne: Vaccination to the virus that can cause cervical cancer, HPV, can help reduce your risk of getting cervical cancer.  Avoiding and stopping smoking is also important to reduce your risk. Regular follow up with your gynecologist or primary care physician for a Pap smear screening. Pap smear is also important because abnormal cells and precancer can be detected and treated before they cause cancer.