Author: Daniel Donato, MD
A Papanicolaou (Pap) test is a screening for cervical cancer and an important part of your healthcare routine. If you have an abnormal Pap test result due to the presence of gynecologic cancer, you can count on the cancer experts at Rocky Mountain Cancer Centers (RMCC) to guide you through the journey with tailored treatment options and a robust spectrum of support.
What Is a Pap Test?
During a Pap test, your healthcare provider will collect a sample of cells from your cervix. To open up the vagina and clearly see the cervix, the healthcare provider will insert an instrument called a speculum. They will then gather a sample of cells from the cervix using a small brush or spatula, which will be sent to a laboratory to test for cervical cancer.
A Pap test can also detect cells that are precancerous, which are abnormal cells that are not yet cancerous but can become cancerous over time. Finding and removing precancerous cells can prevent cervical cancer.
A Pap test can also be paired with an HPV test to search for the presence of human papillomavirus, a sexually-transmitted disease that can lead to cancer-causing mutations in your cells. You may also have an HPV test on its own. If you develop HPV, you may develop genital warts, depending on the type of HPV you contract. According to the Centers for Disease Control and Prevention, 13 different types of HPV that exist can lead to cervical cancer. To reduce the likelihood of contracting HPV during adulthood, a vaccine is recommended for children at the age of 11 or 12.
Who Should Get a Pap Test?
Pap tests are important routine healthcare screenings for women that can potentially save your life. If you have cervical cancer or abnormal cells in your cervix, the earlier they are found, the better your chance for successful treatment. The removal of precancerous cells from the cervix prevented cervical cancer 95% of the time.
The American College of Obstetricians and Gynecologists recommend women start Pap test screening at age 21. If your first test is normal, you should have a Pap test every three years, or as directed by your healthcare provider.
Most women don’t have to have Pap tests after age 65, so long as they have had three consecutive normal results during the past 10 years. You may not need to receive Pap test screenings if you have had a hysterectomy. Your healthcare provider will help you decide when you can safely stop Pap tests.
Pap Test Results
Pap test results typically take 1–3 weeks to come back from the lab. Your results will either be normal, abnormal, or unclear. Here’s what these results mean:
- Abnormal: This doesn’t necessarily mean you have cervical cancer. Abnormal Pap test results mean that the cells that your healthcare provider collected look abnormal, or the laboratory detected changes to the cells on your cervix. Your provider will require additional tests to find out what your abnormal result means.
- Normal: No changes were found to the cells on your cervix. You should still get additional Pap tests in the future, and your healthcare provider will help you decide when to come in for future screening.
- Unclear: Unclear results mean that the cells on your cervix could be abnormal, but the lab isn’t certain. You can also receive an unclear result if the lab didn’t have enough cells to test, the sample was contaminated with blood or mucus, or you have an infection or changes in hormones.
After Abnormal Results
If you receive an abnormal Pap test result, our gynecologic oncology specialist will need to conduct additional tests to find out what your results mean. These tests are typically a colposcopy or a cervical biopsy.
During a colposcopy, our specialist will use a tool called a colposcope that allows him to magnify his view of the cervix. He will have cleaned your cervix with a vinegar or iodine solution, which highlights any abnormal cells. He will then be able to see any abnormalities on your cervix. Abnormalities could look like abnormal blood vessel patterns, areas that are swollen or worn away, patches of white, or polyps or warts. If he finds any abnormal cells, he will take a sample for biopsy.
If your biopsy returns normal, it is unlikely that you have precancerous or cancerous cells. However, if your biopsy is positive, you most likely have precancerous or cancerous cells. Our specialist may wish to schedule a procedure to remove your abnormal cells.
Your treatment options will vary based on the type of precancer you have. Precancerous cells can be either mild, moderate, or severe.
If you have mild precancerous dysplasia, you may not need any treatment at all. Roughly 60% of mild (dysplasia) goes away on its own. If you have moderate or severe precancer (carcinoma in situ), you could receive one of three treatments at RMCC:
- Cryotherapy – This outpatient procedure is performed in your provider’s office. Compressed nitrogen gas freezes the abnormal cells, killing them. This treatment takes 15 to 20 minutes. You may experience pain or cramping.
- Laser ablation – During a laser ablation, our surgeon will use a precise laser beam to burn off abnormal cells. You can receive this treatment in our surgeon’s office under local anesthesia or in an operating room under general anesthesia.
- Loop Electrosurgical Excision Procedure (LEEP) – LEEP uses an electric current through a loop of wire to slice off a section of your cervix. While LEEP can be a critical procedure to determine if your cancer is invasive, at RMCC, we use LEEP only when we have to, especially for young women who want to have children because it can damage your cervix.
If you have more advanced-stage cancer, you may need chemotherapy, radiation therapy, or surgery. To personalize your treatment to meet your unique needs, you will work with our surgeon to determine which option or combination of options to manage gynecologic cancers are right for you.
For more information about abnormal Pap tests, watch our gynecologic oncology videos.