One of the most frightening times in a woman's life is when the gynecologist calls and says that her Pap smear results are abnormal. Although you might think an abnormal Pap smear means that you have cervical cancer, the fact is that the majority of abnormal Pap smears are not caused by cervical cancer.
Because the Pap smear can only screen for potential problems, not diagnose them, your gynecologist may want to take a closer look at your cervix to determine the cause of your abnormal Pap smear results. He or she will perform an examination called a colposcopy. Your doctor may order this procedure if you have Pap smear results that:
- indicate cervical dysplasia or cervical cancer
- show evidence of HPV
- show first-time or repeat atypical squamous cells of undetermined significance (ASCUS)
Colposcopy is a simple, 10- to 15-minute procedure performed in a gynecologist's office. It is usually painless or may cause mild cramping. You are positioned on the examination table like you are for a Pap smear, and an acetic acid (such as common table vinegar) is placed on the cervix.
Your physician will use a colposcope -- a large, electric microscope that is positioned approximately 30 cm from the vagina -- to view your cervix. A bright light on the end of the colposcope lets the gynecologist clearly see the cervix. During the colposcopy, the gynecologist focuses on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas -- the whiter the area, the worse the cervical dysplasia.
If your physician can view the entire abnormal area through the colposcope, a tissue sample or biopsy is taken from the whitest abnormal areas and sent to the lab for further evaluation. You will be asked to return to the office for results and to discuss further management for your abnormal Pap smear.