Pap Smear Abnormalities

The Cervical Screening Test

All women aged 25 to 74 years should have a Cervical Screening Test every five years (more often if you have an abnormal result) with their local doctor. The Cervical Screening Test takes a sample of cells from the cervix, which are used to look for infection from the Human Papilloma Virus (HPV). Certain strains of the HPV virus are strongly related to cervical cancer, and almost all cases of cervical cancer result from HPV. The Cervical Screening Test replaced the Pap smear in late 2017.

The Results

The results that are reported for your cervical screening test will, in part, depend on the reason for your test. In all women, the presence or absence of HPV is the first part of the result and will be reported as DETECTED or NOT DETECTED for:
  • HPV 16
  • HPV 18
  • HPV other

In women where any HPV has been detected, or if you have symptoms which may be related to any cervical disease such as bleeding after intercourse or between periods, then the pathologist will look at the cells collected from the cervix and report the cytology, or appearance of those cells. The cytology report will be underneath the HPV report and may state:

  • No abnormality seen
  • Possible low-grade intraepithelial lesion (Possible LGIL)
  • Low grade intraepithelial lesion (LGIL)
  • Possible high-grade intraepithelial lesion (Possible HGIL)
  • High grade intraepithelial lesion (HGIL)
  • Malignancy

It is important that your sample contains two different types of cells (squamous and columnar cells), to ensure the entire region where cervical cancer may occur has been sampled at the time of the Cervical Screening Test. Therefore, the pathologist will look for these cells and report:

  • The endocervical component PRESENT or ABSENT

When this component absent it may make interpretation of your Cervical Screening Test difficult. If this happens to you, Dr Budden will discuss this and how it may impact on the recommendation for repeat testing or treatment.

Finally, many pathologists will report an overall conclusion to assist your local doctor in deciding what action is required.  This may be as simple as a rescreen in 5 years or it may state that specialist consultation is recommended.  The important thing to remember here is that it is only a guide for your local doctor as they are the person who has a complete understanding of your history and current symptoms, which the pathologist may not have.