When your Pap smear is positive

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The likely culprits

About 3 to 5 percent of women experience an abnormal Pap smear -- a test for cervical cancer -- at some point in their lives. Cervical cancer is the most unlikely cause; in fact, everything from a yeast infection to the human papillomavirus (HPV), a sexually transmitted disease, can result in an abnormal Pap smear. Here are possible reasons for an abnormal Pap smear and the latest treatments: --Deborah Pike Olsen

Type of abnormality: What it means: Treatment:
Atypical squamous cells of unknown significance (ASCUS) Your Pap smear wasn't completely normal, but did not meet diagnostic criteria for a lesion. Your doctor has three options: repeat your Pap test in three to six months, test you for HPV or perform a colposcopy, a visual inspection of the cervix.
Low-grade squamous intraepithelial lesion (LSIL) You have a precancerous lesion caused by HPV. More than half of these lesions disappear on their own within 24 months. Still, your doctor should perform a colposcopy.
High-grade squamous intraepithelial lesion (HSIL) You have a more serious precancerous lesion caused by HPV. Your doctor will remove tissue or destroy the abnormal cells. A biopsy is taken to rule out cancer. This treatment is typically effective.
Atypical glandular cells You may have a precancerous condition or cancer of the cervix or uterus. This represents less than 10% of abnormal Pap smears. A colposcopy is performed, and a biopsy is taken. In premenopausal women with a negative biopsy, Pap smears are repeated every three months.
Adenocarcinoma You have cervical cancer. In early stages, removal of cervix and possibly uterus; for advanced cancers, removal of both, plus radiation.


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