Most times the results of a Pap test are normal. A so-called abnormal result indicates a need for further testing. There can be many reasons for an abnormal result.
Sometimes, cells on the surface of the cervix appear abnormal but not cancerous. Scientists believe that some abnormal changes in cells on the cervix are the first step in a series of slow changes that can lead to cancer later on; in other words, they may be considered precancerous. CDC says cervical intraepithelial neoplasia (or CIN) is the name for a precursor lesion to cervical cancer. The term CIN, along with a number (1 to 3), is used to describe how much of the cervix contains abnormal cells. Abnormal or precancerous cells are also called dysplasia or squamous intraepithelial lesion (SIL). SIL is described as being low-grade (early changes in the size, shape and number of cells) or high-grade (a large number of precancerous cells). High grade SIL can also be called carcinoma in situ. Cervical cancer or invasive cervical cancer, is the term used when abnormal cells spread into the cervix or to other tissues or organs.
The American Society for Colposcopy and Cervical Pathology (ASCCP) says the most common type of abnormal Pap test is an inconclusive result referred to as ASC-US or atypical squamous cells of undetermined significance. There are now new national Consensus Guidelines for dealing with ASC-US. Before these guidelines, women with ASC-US would usually either get several repeat Pap tests or undergo a colposcopy, during which the cervix is examined using a special type of microscope and biopsies can be taken. The new guidelines say the other approaches may still be used, but HPV testing is preferred whenever liquid-based Pap tests are used. If the liquid test is used, the laboratory can test the same sample used for the original Pap test for HPV. ASCCP calls HPV the primary cause of cervical cancer. The test quickly identifies those women who are HPV positive and need further evaluation. ASCCP says women who are HPV negative are less likely to have cervical cancer but that they still need regular annual Pap tests
The National Cancer Institute (NCI) says that if precancerous conditions are present, there may be no apparent symptoms or problems. In the early stages of cervical cancer, there may also be no symptoms. In its later stages, ACOG says cervical cancer can cause:
* abnormal vaginal bleeding or spotting
* abnormal discharge