The Pap smear (Papanicolaou test) is a screening test used to detect abnormal cervical cells, including precancerous changes, cervical cancer, and infections. It involves collecting a sample of cells from the cervix and examining them under a microscope.
✅ Screen for cervical cancer
✅ Detect precancerous or abnormal cells (Cervical Intraepithelial Neoplasia – CIN)
✅ Identify infections or inflammation
✅ Monitor women with previous abnormal Pap smears or HPV infection
📌 Recommended for: Women aged 21–65 years, with frequency depending on risk factors and prior results.
| Result Type | Interpretation | Next Steps |
|---|---|---|
| Normal (Negative for Intraepithelial Lesion or Malignancy – NILM) | No abnormal cells detected | Routine screening (as per guidelines) |
| Atypical Squamous Cells of Undetermined Significance (ASC-US) | Slightly abnormal squamous cells, may be related to HPV | HPV test recommended; repeat Pap in 6–12 months |
| Low-Grade Squamous Intraepithelial Lesion (LSIL) | Mild abnormalities, often caused by HPV | HPV test; possible colposcopy if persistent |
| High-Grade Squamous Intraepithelial Lesion (HSIL) | More severe abnormalities, may indicate precancerous changes | Colposcopy and possible biopsy |
| Atypical Glandular Cells (AGC) | Abnormal glandular cells, possible precancerous or cancerous changes | Further evaluation with colposcopy, endometrial biopsy |
| Squamous Cell Carcinoma / Adenocarcinoma | Suggests possible cervical cancer | Urgent colposcopy and biopsy required |
📌 If HPV testing is positive, additional follow-up may be needed, even with a normal Pap smear.
🔹 Human Papillomavirus (HPV) – Most common cause of cervical abnormalities
🔹 Inflammation or infection – Yeast, bacterial vaginosis, herpes
🔹 Hormonal changes – Seen in pregnancy or menopause
🔹 Recent sexual activity or irritation – Can cause mild cellular changes
🔬 If Normal (NILM):
✔ Continue routine screening (every 3 years for Pap alone or 5 years if combined with HPV test).
🔬 If Abnormal (ASC-US, LSIL, HSIL):
✔ HPV testing – Determines risk of high-risk HPV strains
✔ Colposcopy – A closer examination of the cervix with a biopsy if needed
✔ Biopsy (if severe changes are found) – Confirms precancerous or cancerous changes
✔ HPV Vaccination – Protects against high-risk HPV types (recommended for ages 9–45)
✔ Regular Pap & HPV Tests – Early detection prevents cervical cancer
✔ Safe Sexual Practices – Reduces HPV transmission risk
✔ Smoking Cessation – Smoking increases cervical cancer risk