What it is
A Pap collects cells from the surface of the cervix. An HPV test looks for the virus that changes those cells. An abnormal result means something was found, not that anything has been decided.
Most abnormal Paps come from HPV. Most HPV clears on its own within about two years. A small share persists and slowly changes the cells at the surface.
A Pap cannot tell how deep a change goes. Looking at the cervix under magnification and sampling it can. Screening Paps stay with your primary office. Dr. Mueller takes it from the abnormal result forward.
What the result might say
- ASC-US, a few cells look slightly off and the cause is unclear
- LSIL, mild changes that usually mean recent HPV
- ASC-H, a high-grade change cannot be ruled out
- HSIL, high-grade changes in the surface cells
- AGC, glandular cells from higher in the canal look abnormal
- HPV positive for type 16 or 18
- HPV positive for another high-risk type
- Unsatisfactory, too few cells and the test needs repeating
How Dr. Mueller finds the cause
- 1
Bring the report
Dr. Mueller reads the actual lab result, not a summary of it.
- 2
Colposcopy exam
A lighted magnifier examines the cervix after a vinegar wash.
- 3
Cervical biopsy
She takes a small sample from any area that looks changed.
- 4
Pathology report
It describes how deep the change goes.
- 5
Treatment plan
Watch and repeat, or remove the area with a LEEP.
- 6
Follow-up testing
Testing repeats at set intervals until it comes back clear.
Questions people ask
- Does an abnormal Pap mean cancer?
- No. Most abnormal Paps are HPV changes that never become cancer. The follow-up exists to catch the few that would.
- Do you do routine screening Paps here?
- No. Screening stays with your primary care office. Dr. Mueller evaluates the abnormal result they send you with.
- Does a colposcopy hurt?
- The speculum feels like a Pap. The biopsy is a sharp pinch and a cramp, over in seconds.
- What should I avoid before the appointment?
- No sex, tampons or vaginal medicine for 24 hours. They make the cervix harder to read.
- Will HPV go away on its own?
- Most infections clear within about two years. The ones that persist are the ones followed closely.
- Can I still get pregnant after a LEEP?
- Yes. A LEEP removes a shallow layer of cervix. Tell any future pregnancy provider you had one.