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Abnormal Paps
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SouthernBelle3090 posted:
Hi all!
So I'm 22 year old and when I was 18 I had my first abnormal pap, I had a follow up with the colposcopy and biopsy and it came back clear. My next pap wasn't for almost 3 years just due to insurance issues and being negligent basically (I know I know, stupid). Anyways, that was in Sept. of last year and it also came back normal but due to not having insurance I couldn't have another colpo. The results were CIN I, and LSIL, my pap smear I had about a week ago came back abnormal again with ASC-H. I have a colposcopy on Thursday morning and I'm pretty terrified because clearly it didn't heal itself and it's progressively gotten worse. I'm just wondering if anyone else has had the diagnosis with ASC-H and what their outcome was??? Help!
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Anon_6061 responded:
There's no need to beat yourself up. It's actually recommended that pap smears not be started until age 21 and then be repeated every 3 years. This is because many abnormal cells are transient and resolve on their own (revert back to normal) without treatment. So too much screening can lead to overtreatment. Also, cervical cancer generally takes many years to develop.

Here are a few links that may be helpful in understanding cervical changes and abnormal paps -
http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing
http://www.cancer.gov/cancertopics/understandingcervicalchanges
http://www.thehpvtest.com/about-hpv/high-and-low-risk-hpv-types/

According to this information, LSIL and CIN-1 are the same thing, just different ways of saying it. And ASC (-H and -US) is more mild than LSIL (CIN-1) so if your latest pap showed only ASC-H then things have improved. Interestingly, for ASC-US and ASC-H, it says "The cells do not appear normal, but doctors are uncertain about what the cell changes mean."
 
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SouthernBelle3090 replied to Anon_6061's response:
Hi,
First of all, thank you so much for taking the time to reply. I read over the websites you attached, but I still wasn't able to see where it said that ASC(-H or -US) is more mild than (CIN-1). I guess I'm just trying to figure out how bad it is and how much it has progressed since my last pap one year ago.
 
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Anon_6061 replied to SouthernBelle3090's response:
This link http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing says:
"The Bethesda System considers abnormalities of squamous cells and glandular cells separately. Squamous cell abnormalities are divided into the following categories, ranging from the mildest to the most severe." It then lists ASC first (as the mildest) and says "Atypical squamous cells (ASC) are the most common abnormal finding in Pap tests. The Bethesda System divides this category into two groups, which are described below."

This table "What your pap test/HPV test results mean and follow-up" may help you understand your results and next step(s) in screening or treatment:
http://www.cancer.gov/cancertopics/understandingcervicalchanges/page9


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