Pap Smears

The Pap smear your family physician recently obtained from your cervix (the lower part of your womb) has shown some slightly abnormal changes. The Pap smear allows your doctor to look at the skin cells from your cervix and detect problems.

Classification of Pap Test Results

  • Class I  - Normal
  • Class II  - Atypical, inflammation or uterine cells seen
  • Class III  - Dysplastic, mild, moderate or severe
  • Class IV  - Carcinoma-in-situ
  • Class V  - Suspicious for an invasive cancer

Bethesda System

  • Adequacy
    • Satisfactory
    • Limited
    • Unsatisfactory
  • Descriptive
    • Normal
    • Benign
    • Epithelial cell abnormality
    • Atypical squamous cells of unknown significance
    • Low grade squamous intraepithelial lesion
    • High grade squamous intraepithelial lesion
    • Glandular cell abnormality
    • Atypical glandular cells
    • Adenocarcinoma


 Your Pap smear showed one or more of the following changes. Ask your doctor which of these changes you have.

ASCUS (pronounced "ask-us")

ASCUS stands for atypical squamous cells of undetermined significance. These changes in the squamous cells of your cervix mean that the cells on your Pap smear were slightly abnormal. ASCUS may be caused by a vaginal infection or an infection with a virus called HPV (human papillomavirus, or wart virus). Your doctor will talk with you about the options of looking at your cervix with a microscope (colposcopy), or repeating your Pap smear every six months for two years.


AGUS stands for atypical glandular cells of undetermined significance. These changes in the glandular cells of your cervix mean that these cells were slightly abnormal on your Pap smear. AGUS can occur with infections or with an abnormality of the skin cells on the surface of your cervix or in the canal of your cervix. Your doctor will tell you how the abnormal results on your Pap smear need to be evaluated. Your doctor may recommend repeat Pap smears or colposcopy.


LSIL stands for low-grade squamous intraepithelial lesion. This is a common condition of the cells of the cervix and often occurs when HPV wart virus is present. These changes in the cervix can be present even if you and your sexual partner are monogamous and have never had visible warts. Changes due to LSIL often get better with time. Your doctor will talk with you about whether you need to have Pap smears every six months for two years or whether you should have colposcopy.


If inflammation is present in the cells on the Pap smear, it means that some white blood cells were seen on your Pap smear. Inflammation of the cervix is very common and usually does not mean there is a problem. If the Pap smear showed that the inflammation is severe, your doctor may want to find the cause, such as an infection. You may also need to have another Pap smear in six months to see if the inflammation has gone.


Hyperkeratosis is a finding of dried skin cells on your Pap smear. It is often a change in the cells of the cervix that occurs from using a cervical cap or diaphragm or from having a cervical infection. Hyperkeratosis rarely needs any more evaluation than a repeat Pap smear in six months. If the hyperkeratosis is still present on the repeat Pap smear, your doctor may want to repeat your Pap smear in another six months or perform colposcopy.

Contact Information

Please be sure that you let your doctor's office know if you move or change your phone number so that you can be contacted with the results of your Pap smears or to arrange any other follow-up tests you may need.


This information provides a general overview on slightly abnormal Pap smears and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.