Atypical Pap Smear
Many conditions can be associated with an atypical Pap smear. Pap smear is commonly performed to reveal the presence of cellular changes on the cervix that are associated with a high risk for cancer of the cervix. In addition, Pap smear provides the possibility to examine cervical tissue and detect different cervical and vaginal infections. If atypical cells are found on the cervix, it is usually necessary to realize a more accurate evaluation of cervical tissue status through colposcopy and biopsy.
In some cases Pap smear yields false negative or false positive results. In case of a false positive result, there are no abnormalities on the cervix, but Pap smear is mistakenly classified as atypical. A false negative result means that atypical Pap smear is considered by mistake to be normal since the doctor has missed atypical cells during microscopic examination. Sometimes the test gives a false result when the patient has had intercourse or used vaginally some medication within 2 days before Pap smear.
There are different factors which can be the reason of atypical Pap smear. Most often Pap smear results revert to normal on their own within 6-12 months. Atypical cells may appear in the cervical tissue due to an inflammation caused by different viruses or bacteria. Cervical abnormalities may go away after specific treatment for cervical infection is performed. Cellular abnormalities on the cervix may occur due to hormonal changes, for example, in menopausal women.
Another cause of an atypical Pap smear is the presence of cervical dysplasia. This is a disease characterized by the presence of cervical cell changes able to degenerate into malignant lesions if left untreated during a long period. The diagnosis of cervical dysplasia is made through additional tests, colposcopy and biopsy, that allow to assess the present lesions. Based on the risk for cancer, dysplasia may be classified as low grade or high grade. The majority of low grade dysplasias disappear on their own, without any specific therapy. The presence of a high grade dysplasia is most often the indication for a surgical removal of the lesions. If a woman with cervical dysplasia does not receive treatment, the risk of cancer increases considerably.
Cervical dysplasia is very often associated with human papilloma virus (HPV) infection. Cervical cancer usually develops in women with cervical dysplasia, infected by high risk oncogenic HPV strains. About 95% of cervical cancers are caused by high risk HPV strains, especially HPV 16 and HPV 18. Therefore, it is highly recommended for patients with an atypical Pap smear to be examined for HPV.
