QuestionMy 15 year old step daughter had an abnormal pap, she was told to come back in three months to have another, which she did.
On this last one the pap was different, instead of a slide they used liquid. (I believe this was the difference)
Anyway it came back atypical Squamous of the unknown. Can not rule out high grade intrapelal (sp?) lesion.
I looked this up on the internet and it said that is caused by hpv or genital warts.
I have three questions :
1. Is HPV or genital warts the ONLY cause of this squamous.
2. Is this something we can catch from her through casual contact?
3. This is a cancer? Or a precancer?
She is scheduled for a consult with the Dr. next week and she is going to have to have a biopsy.
Thanks.
AnswerEvery women who is over 21 years of age or is sexually active should have a PAP smear. We used to perform a PAP smear by taking a sample from the cervix on a Q-tip and swabbing it on a slide. For the past 10 years, we have been using a "liquid based" PAP smear and we place the swab in a vial of liquid. It gives a better result. The PAP smear is a test for cervical cancer. The area where the vagina meets the cervix is called the "transformation zone". This is where the squamous cells of the vagina abut against the columnar cells of the cervix. This is the area where we can get a "disorder" of the cells. Disorder of the cells can lead to cancer of the cervix. It is a spectrum as follows: Normal, ASCUS (atypical squamous cells of undetermined origin), LSIL (low grade squamous intraepithelial lesion), HSIL (high grade squamous intraepithelial lesion), CIS (carcinoma in situ), and finally cancer. It is our job as gynecologists to pull the abnormal cells back to normal cells. Usually, abnormal cells of the cervix can be caused by an infection called "human papilloma virus" or HPV. This is a sexually transmitted virus, but it can be pickup up elsewhere as well. If your daughter had ASCUS, she merely has to repeat the PAP smear in one year, unless they also found that she had some suspicious sub-types of HPV. (They would have told her about that if it occurred). If it is normal next year, she just has to follow her PAPs once a year. If it is again abnormal or worse next year, she will need a more closer exam called a "colposcopy". HPV is the organism that also causes genital warts, but that does not mean that she has warts. You cannot catch it from her through casual contact. She has nothing to catch. She merely has some disorder of the cells of her cervix. This is not cancer, but if she does not follow the instructions of her doctor, it can progress closer and closer to cancer of the cervix. Usually it disappears. The biopsy is done through the colposcope. Don't worry.
