Question Title: Abnormal pap smear in a 19 yr.old

Forum: The Maternal and Child Health Forum
Topic: Childhood Disease

Dear Dr.

My college daughter just called home in tears. She had gotten her first abnormal pap smear. They stated to her that she either had an infection or has cancer. But they did not do any other tests, a culture, or anything. They just said to wait and come back in 3 mos. for a repeat pap smear. She will be home soon, and has agreed to get a second opinion from a gynecologist up here. I know that abnormal pap smears are almost common, but she's so young. She has only been on the pill for approx. 2 years, and has changed her pill this year to one that has more estrogen in it. Could the estrogen increase her chances for getting cancer. Breast cancer has run in her great grandma and grandma, but only when they were in their 70's. Her aunt who is pre-menopausal has a history of troubling hormones and abnormal pap smears, but no cancer. I am her mother with all good pap smears and mammos. What does the research say about abnormal pap smears and the risk of cancers. I would like to know. I am also going to follow up with a second opinion, because I do not trust on campus drs. What are some questions that I should ask the gynecologist. I would appreciate any answers here being that this is all new to me and her dad. We are concerned. Thanks.

It is really difficult to answer the question without knowing what the pap smear report actually gave as the diagnosis. Your daughter may want to request a copy of the pap smear report.

The pap smear report that calls for a repeat in 3 months is "Atypical squamous cells of undetermined significance ASCUS ". One way to look at it is imagining a pathologist looking under the microscope and saying: This is not bad, not even a little bit bad.. but it is not totally normal.. So we will just have the GYN repeat the test in several months. The diagnosis in many ways sounds "bad" --- but it really isn't.

The next grade up in abnormal pap smears is "ASCUS suggesting dysplasia". In this case the recommended follow up is colposcopy - the GYN looks at the cervix using a special magnifing instrument to make sure everything is normal.

Birth control pills and family history of breast cancer are not related to abnormal pap smears.

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