The PAP test has been in use since the 1950s to screen for cervical cancer. Screening for cervical cancer has significantly reduced the cases of cervical cancer. Current cervical cancer screening guidelines recommend screening starting at age 21 and ending at age 65 for most women.

What is an abnormal Pap Smear?

A PAP test is a screening procedure where your OB/GYN swabs the cervix to obtain and identify abnormal cells that could lead to cervical cancer. An abnormal PAP smear means precancerous cells were found.

What is cervical dysplasia?

Cervical dysplasia is the presence of precancerous cells on the surface of the cervix usually caused by HPV. It causes no symptoms and is typically identified first, by an abnormal Pap test.

It may be mild, moderate, or severe depending on how the cells look under a microscope and the amount of cervical tissue that is affected.

Why Human Papillomavirus (HPV)?

Genital HPV infection is the most common sexually transmitted infection in America. Nearly everyone will get HPV at some time in their lives. By age 50, at least 4 out of 5 women will have been infected with HPV. According to the CDC, more than 42 million Americans are currently infected with HPV.

The HPV virus causes precancerous changes (cervical dysplasia) in the cervix, and it is what the PAP test is designed to identify. About 10% of women with an HPV infection of their cervix will develop a long lasting infection that increases their risk of developing cervical cancer.

Most low-risk HPV infections cause no symptoms and go away on their own when the body’s immune system naturally gets rid of the virus within a few years of infection. Low-risk HPV infections, however, can cause genital warts.

There are more than 13 high-risk types of HPV that can stay on the cervix for a longer time and can cause cervical cancer. At least one of these types can also cause vaginal and vulvar cancer in women; anal cancer in both men and women; and throat cancer in both men and women. Every year, HPV causes about 36,000 cases of cancer in both sexes.

What additional testing may be needed?

When your Pap test results are abnormal, Dr. Dwaita Patel will likely order another Pap, a test for HPV, and/or a colposcopy to examine the cervix and collect abnormal potentially precancerous cells to be diagnosed by a pathologist.

A colposcopy is an office procedure that involves the use of a special instrument called a colposcope, or a magnifying microscope, that allows Dr. Patel to identify more clearly the cells of the cervix that may be infected by the HPV virus. When any abnormal cells are identified, your OB/GYN will take a biopsy of the tissue and will send it to a lab to identify precancerous cells and/or cancer of the cervix. Dr. Patel will explain the procedure and what to expect.

The HPV test can be done at the same time as the Pap test. The cells are obtained by gently brushing the cervix and they are sent to the lab for HPV testing. How often you would get an HPV retest depends on your age, medical history, and the results of your last Pap test.

What is the treatment for cervical dysplasia?

When precancerous cells are identified, they can be removed to prevent the development of cervical cancer. Dr. Patel will determine your risk and treatment based on your health, medical history and the type and extent of the lesions.

The most common procedures to remove abnormal cells to prevent development of cervical cancer include:

• Loop Electrosurgical Excision Procedure (LEEP). LEEP is procedure that can be performed in the office. After numbing the cervix, a small electrical wire loop is inserted to remove abnormal cells. The procedure usually takes about ten minutes and there may be some discomfort or cramping. The cells are sent to a lab to be diagnosed.
• Cryosurgery is an office procedure that involves the use of a chemical to freeze the abnormal cervical cells which kills them. Normal cells will grow to replace the abnormal cells. Cryosurgery is effective to cure abnormal cells about 90% of the time.
• Laser ablation. Laser energy is targeted to destroy precancerous cells on the cervix. It is typically an outpatient procedure that is performed under local anesthesia.

With careful follow up and treatment, cervical dysplasia can be eliminated to prevent cervical cancer. Contact Dr. Patel at City OB+GYN to receive a respectful and private consultation, and state-of-the-art treatments.