Possible Results from a Smear Test

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A smear test, or Pap test, is a screening test that does not provide a definitive diagnosis but rather raises suspicions about certain conditions. The test can reveal two types of cell changes known as High-Grade Squamous Intraepithelial Lesion (HSIL) and Low-Grade Squamous Intraepithelial Lesion (LSIL).

In approximately 60% of LSIL cases, a biopsy reveals a normal cervical structure. The remaining cases may show the first pre-cancerous lesion of the cervix, known as CIN1. However, in 5% of LSIL cases, early-stage or invasive cancer, an advanced form of cancer, can be observed.

For HSIL cases, which involve severe cell changes, around 30-40% of biopsies may still show normal cervical tissue. However, the rates of detecting CIN2, CIN3, or early-stage cancer are higher in biopsies showing abnormal cell changes.

Another common and perplexing result encountered is ASC-US (Atypical Squamous Cells of Undetermined Significance). ASC-US signifies an unexplained cell change, which can result from hormonal fluctuations, bacterial infections, or lactation (breastfeeding). The crucial step in patients with ASC-US is determining whether HPV infection is the cause. The primary test conducted is the HPV-DNA test, which checks for the presence of HPV. If the HPV-DNA test is positive, further diagnostic tests are performed.

In some cases, smear tests may also detect benign infections. Common cervical inflammations in women may manifest as reactive cell changes in the smear, leading to the administration of medication or surgical procedures for treatment.

It is essential to emphasize that a definitive diagnosis and appropriate follow-up steps are determined based on comprehensive evaluations, including additional tests, colposcopy-guided biopsies, and clinical judgment by a healthcare professional.