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Understanding Cervical Changes: A Health Guide for Women

  • Posted: 01/21/2010

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Table 1: What Your Pap Test/HPV Test Results Mean and Follow-Up

AGC

Possible ResultWhat It Means to YouWhat Your Health Care Provider May RecommendPossible Outcomes
NormalOnly normal cells were seen on the Pap test.Continue to get Pap tests at least once every 3 years.A False Negative (Looks Normal, But May Not Be)
The Pap test is a very good screening test, but it is not perfect. A single Pap test may miss up to 20 percent of abnormalities. Changes that are missed once are usually found the next time. This is why it is important to get a Pap test at least once every 3 years.
ASC-USASC-US (atypical squamous cells of undetermined significance)
  • Some cells from the lining of the outer cervix (also called squamous cells) do not appear normal.
  • Your health care provider will need to do additional tests to clarify the results.
  • Follow-up with repeat Pap tests every 6 months
  • Testing for high-risk HPV
  • Immediate colposcopy (a test that can be done in the doctor's office to get a magnified view of your cervix)
  • Biopsy
  • Estrogen cream

Abnormal Pap Test Result
If a repeat Pap test is abnormal, your health care provider will probably recommend a colposcopy.

Positive HPV Test Result
If your HPV test is positive, your health care provider will probably recommend a colposcopy.

Negative HPV Test Result
If your HPV test is negative, your health care provider may recommend a repeat screening in 1 year. Because ASC-US can also be caused by an estrogen deficiency, your health care provider may prescribe an estrogen cream if you are near or past menopause.

Abnormal Colposcopy Result
If your colposcopy is abnormal, your health care provider may do a biopsy, endocervical curettage, or both.

ASC-H

ASC-H (atypical squamous cells, cannot exclude HSIL)

  • Cervical cells do not appear normal.
  • A high-grade lesion may be present, but the cell changes are too minor to be sure.

AGC (atypical glandular cells)

  • Some glandular cells in the lining of the cervix appear abnormal.
  • Colposcopy
  • Biopsy

Normal Colposcopy Result
If cervical tissue looks healthy, your health care provider may not need to do any further testing or treatment right away, but may recommend an HPV test in 1 year or repeat Pap tests after 6 and 12 months.

Abnormal Colposcopy Result
If your colposcopy is abnormal, your health care provider may do a biopsy, endocervical curettage, or both.

LSIL

LSIL (low-grade squamous intraepithelial lesion)

  • Squamous cells are abnormal, but are usually not precancerous.
  • Colposcopy
  • Biopsy

Normal Colposcopy Result
If cervical tissue looks healthy, your health care provider may not need to do any further testing or treatment right away but may recommend an HPV test in 1 year or repeat Pap tests after 6 and 12 months.

Abnormal Colposcopy Result
If your colposcopy is abnormal, your health care provider may do a biopsy, endocervical curettage, or both.

Precancer

HSIL

AIS

If you have one of the results below, it is very important that you get the necessary tests and treatments.

HSIL (high-grade squamous intraepithelial lesion)

  • The lesion is precancerous; without treatment, it may turn into invasive cancer.

AIS (adenocarcinoma in situ)

  • A precancerous lesion is found in the glandular tissue of the cervix.
  • Colposcopy
  • Biopsy

Normal Colposcopy Result
Even if cervical tissue looks healthy, your health care provider may need to do further testing or treatment, including loop electrosurgical excision procedure (LEEP) or repeat colposcopy and Pap tests after 6 and 12 months.

Abnormal Colposcopy Result
If your colposcopy is abnormal, your health care provider will probably do a biopsy, endocervical curettage, or both.

CancerCancer cells are present in the cervix.
  • Colposcopy
  • Biopsy

Your health care provider will probably refer you to a gynecologic oncologist.

Abnormal Colposcopy Result
If your colposcopy is abnormal, your health care provider will probably initially do a biopsy, endocervical curettage, or both, and then refer you to a gynecologic oncologist for further evaluation and treatment.

In some cases, follow-up treatment may be different for women who are younger than age 21 or pregnant.

This table is based on the American Society for Colposcopy and Cervical Pathology (ASCCP) consensus guidelines.

For more information on cells of the cervix, see the What is the Cervix in this booklet.