Colposcopy and management of abnormal Pap smears

Our providers follow guidelines laid out by the American Society for Colposcopy and Cervical Pathology.

The majority of abnormal Pap smears do not represent cervical cancer. Because the Pap smear can only screen for potential problems rather than diagnose them, your gynecologist may want to take a closer look at your cervix to determine the cause of your abnormal Pap smear results. She will perform an examination called a colposcopy.

Your doctor may order this procedure if you have Pap smear results that:

  • Indicate a cervical cellular abnormality
  • Show evidence of HPV
  • Show repeat atypical squamous cells of undetermined significance (ASCUS)

Colposcopy is a simple procedure performed in our office that lasts approximately 10-15 minutes and may cause mild discomfort in some women. You are positioned on the examination table like you are for a Pap smear, and acetic acid (such as common table vinegar) is placed on the cervix. Your provider will use a colposcope — a large microscope positioned 10-12 inches outside of the body to view your cervix. A bright light on the end of the colposcope lets your gynecologist clearly view the cervix. During the colposcopy, your gynecologist focuses on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas and the whiter the area, the more suspicious for cervical dysplasia.  These are the areas your provider will biopsy. You may be asked to return to the office for results and to discuss further management for your abnormal Pap smear. Many conditions diagnosed through a colposcopy are followed in a minimalist manner by annual Pap smear with HPV testing. Additionally, we will want all women age 45 and under to be proactive about preventing these problems with HPV vaccinations.