Monthly Archives: March 2007

What Does It Mean When Your Doctor Says “Your Pap Smear Is Abnormal”?

A Pap Smear is a test done on women by doctors to screen them for cervical cancer. Your doctor will get samples of your cervical cells and send them to a lab where trained specialist look at your cervical cells under a microscope to see if they see any early cancer changes.

When your doctor tells you that your Pap Smear was “abnormal”, it could mean various things. It could mean that your results came back as one of the following:
1. ASCUS: Atypical Squamous Cells of Undetermined Significance
2. LSIL: Low grade Squamous Intraepithelial Lesions
3. HSIL: High-grade Squamous Intraepithelial Lesions
4. AGUS: Atypical Glandular cells of Undetermined Significance
5. Inflammation: This may indicate presence of white blood cells which may indicate that you have a type of infection
6. Hyperkeratosis: This means that there are dried skin cells on your pap smear. This may be due to the use of cervical caps or diaphragm

Based on your specific pap smear result, your doctor may advise you to either get a repeat pap smear in 4 to 6 months or tell you to have a special test called a Colposcopy.

A colposcopy is a way for your doctor to directly look at your cervix closely under a magnifying scope. Your doctor may use saline to clean your cervix. Then, your doctor will apply vinegar solution to your cervix. This will help your doctor visualize your cervix better. If he or she feels that there are any abnormalities on the cervix, a biopsy (a tissue sample) will be taken. The sample will then be sent to a special lab for them to be analyzed.

There are some things you can do to help “heal” your cervix and protect yourself from future abnormal pap smears.
-Do not smoke
-Eat healthy: green leafy vegetables, fresh fruits, tomatoes and dark yellow or orange vegetables, such as carrots and squash. There is little evidence to support this, but it is thought that these foods are high in antioxidants and folic acid which help your body fight against the virus which causes abnormal changes in your cervix.
-Practice Safe Sex

Read article by Dr. Pandya to learn more about Cervical Cancer and Cervical Cancer Prevention click here
For a patient handout on Abnormal Pap Smears go to Familydoctor website
Click here to learn more about Colposcopy

A New Way to Prevent Cervical Cancer

Cervical cancer is cancer of the cervix which is the lower part of your uterus that enters into the vagina. It has been found that a virus called the Human Papillomavirus (HPV) is linked to cervical cancer. This virus has also been linked to genital warts and other less common genital cancers— including cancers of the anus, vagina, and vulva (area around the opening of the vagina).

There are about forty different types of HPV, each one carrying a different amount of risk of cervical cancer. The highest risk cervical cancer causing HPV strains are 16 and 18 which cause about 70% of all cervical cancers.2

Most women have no symptoms of cervical cancer therefore it is important to be regular with your pap smears to detect if you have early changes of this type of cancer.

In June 2006 the first vaccine to prevent cervical cancer and other diseases in females caused by certain types of genital Human Papillomavirus was released. The vaccine is called Gardasil® and it protects against four HPV types, which together cause 70% of cervical cancers and 90% of genital warts.2

The vaccine is currently recommended for all women 9 to 26 years of age. It is felt that the vaccine is most effective if given to non-sexually active women as women who are sexually active may have already been exposed to the virus strains covered in the vaccine. However, just because you are sexually active does not mean that you should not or cannot get the vaccine.

This vaccine comes in a series of three shots over a 6-month period. The second and third doses are given 2 and 6 months (respectively) after the first dose.

Because the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancer or genital warts. About 30% of cervical cancers will not be prevented by the vaccine, so it will be important for women to continue getting screened for cervical cancer by getting regular Pap Smear tests. Also, the vaccine does not prevent about 10% of genital warts—nor will it prevent other sexually transmitted infections (STIs). So it will still be important for sexually active adults to reduce exposure to HPV and other STIs.1

This vaccine does not treat existing HPV infections, genital warts, pre-cancers or cancers.

Am I at Risk of Having Cervical Cancer?
Women who are at risk of developing cervical cancer include those who:

-Have history of sexually transmitted diseases
-Have history of human papillomavirus (HPV) infection
-Smoke (While nicotine is not considered a causative agent, smoking may predispose a
woman to develop cervical cancer by lowering her immune system)
-Come from low socioeconomic status
-Have had two or more lifetime sexual partners
-Have a low immune system (example: have AIDS, are on chemotherapy)

How Can I Prevent Cervical Cancer?
-Abstinence: The only SURE way to prevent cervical cancer is abstaining from all sexual activity
Sexually active women can help prevent and/or decrease risk of cervical cancer by:
-Pap Smears: Getting regular Pap Smears from your physician
-Limit the number of sex partners as having more sexual partners puts you at a higher risk
of getting the virus
-Being in a mutually faithful relationship with someone who has had no other or few sex
partners, or by limiting their number of sex partners. But even persons with only one
lifetime sex partner can get HPV, if their partner has had previous partners.
-Using Condoms: It is not known how much protection condoms provide against HPV, since
areas that are not covered by a condom can be exposed to the virus. However, condoms
may decrease the risk of genital warts and cervical cancer. They can also reduce the risk
of HIV and some other Sexually Transmitted Infections, when used all the time and the
right way.

Where Do I Get the HPV Vaccine?

Ask your primary care doctor about whether you qualify to get the vaccine and if they carry it.
Also, contact your insurance company to see if they cover the vaccine cost. As of 3/2007 it costs approximately $120 for each shot ($360 for the series). Some states also provide free or low-cost vaccines at public health department clinics to people without health insurance coverage for vaccines.

Are There Any Precautions About the Vaccine?
Women who are pregnant or are allergic to any component of the vaccine should not receive this vaccine.

For more information on Cervical Cancer and HPV vaccine go to the following links:
1. Center for Disease Control and Prevention
2. Merck Pharmaceuticals