Abnormal Pap- this is normal, right?

from wikky- so grain of salt needed:

Worldwide, cervical cancer is the fifth most deadly cancer in women.[43] It affects about 1 per 123 women per year and kills about 9 per 100,000 per year.[citation needed]

In the United States, it is only the 8th most common cancer of women. In 1998, about 12,800 women were diagnosed in the US and about 4,800 died.[3] Among gynecological cancers it ranks behind endometrial cancer and ovarian cancer. The incidence and mortality in the US are about half those for the rest of the world, which is due in part to the success of screening with the Pap smear.[3]

In Great Britain, the incidence is 8.8/100,000 per year (2001), similar to the rest of Northern Europe, and mortality is 2.8/100,000 per year (2003) (Cancer Research UK Cervical cancer statistics for the UK). With a 42% reduction from 1988-1997 the NHS implemented screening programme has been highly successful, screening the highest risk age group (25-49 years) every 3 years, and those ages 50-64 every 5 years.

I've just been diagnosed with a polyp on my cervix. I asked my GP if I therefore could request annual paps so as to be on the lookout for further problems and he said no! 

I don't understand why the hesitancy to have annual pap smears. Why does the US do them and not the UK?

Polyps are not usually precancerous, so I can see why your GP might not want to retest you yearly. Sorry. 

Penrose is correct about the balance between cost and benefit. To sit my NHS competency exam, I had to go on a training course and one of the topics covered was the frequency of smears and how they came to that decision. Based purely on statistics, they decided that you get the most benefit for the least cost based on a 3 yearly schedule for woman with a normal history.

I don't really disagree with it honestly. The NHS has a call and recall system that the US lacks. It also covers every woman within a certain age group. The US  does not have that either. It's easy to look at just the one aspect (every year vs every 3 years) and say that the UK is lacking, but it's not that straightforward.

Penrose is correct about the balance between cost and benefit.

You expressed it so much better than I did, Courtney!  Thank you! 

I've just been diagnosed with a polyp on my cervix. I asked my GP if I therefore could request annual paps so as to be on the lookout for further problems and he said no! 

I don't understand why the hesitancy to have annual pap smears. Why does the US do them and not the UK?

many places in the states are moving to the every 3 year model. I think the research supports it (but i haven't looked myself).

I had my first abnormal test results a few years ago and was so scared to go back for the biopsy because I was scared at what the results might be.  I even cancelled the appt. a couple of times but was going crazy not knowing.  I went back for the tests and shortly after it was all done I received the results by mail saying everything was okay and I did not need to be tested for another 3 years.

Polyps are not usually precancerous, so I can see why your GP might not want to retest you yearly. Sorry. 

 

No need to apologise.   I'm happy to hear that I shouldnt be worrying.

Some states have moved to the 3 yr model.  When I was home I got my BCP from Planned Parenthood without a pap because I had one in the past two years. 

seeing the dr tomorrow to discuss the results.  going to ask for her to retest immediately (it's been 8 weeks already).  if she won't do that, i'll ask to be referred private- that's what i have private insurance for, right?  thanks everyone.

saw my dr.  there were borderline changes to the cells.  mild dyskaryosis.  no evidence of kypotois (almost positive i wrote this down wrong).

she says that there's no reason to retest me immediately- she says there's no point in referring me private b/c they won't test me before (6) months is up either.  she says that even if these mild changes are cancer- they won't turn into cancer for 10 years.  my family history is irrevelent.  she says the vast majority of borderline changes reverse themselves on their own.

i will be recalled (6) months after my initial test.  if i had (3) abnormal smears in a row- i'll be referred to a colonospy. 

Try not to worry. I've had two abnormal Pap smears, years apart, both of which turned out to be normal the second time around. I guess it's an inexact science, and it also depends on which stage you are in your menstrual cycle when you have it done.

I was told that it depends on your cycle as well.  Which makes sense I suppose, you are shedding old cells etc.

Hi meggles~

Could it have been no evidence of koilocytosis?

Borderline changes to mild dyskaryosis is a very common diagnosis. If they said no evidence of koilocytosis, it simply means there was no cellular evidence of HPV. This does not mean HPV is not present, it simply means the cells they sampled do not show the changes.

If you imagine a cell to look somewhat like a fried egg, with the yolk being the nucleus and the white the cytoplasm, a normal cell will have a very tiny yolk and a lot of white. The HPV virus causes the cell's nucleus to enlarge. When there is only a minor enlargement, these cells are called borderline or mild dyskaryosis. When the enlargement of the nucleus is such that it takes over most of the cell, it's called moderate or severe dyskaryosis. This is the diagnosis you don't want!

Koilocytosis is when the cytoplasm around the nucleus is cleared away, leaving a sometimes irregular hole. But this does not happen 100% of the time so the lack of it means very little. If it HAD been present, then you would have known that SOME type of HPV was present, though not necessarily a high risk type.

Mild dyskaryosis is known to regress on it's own, which is why they do not always take an aggressive approach. What your GP said, although it may not be what you wanted to hear, reflects one of the current trends in treatment not only in the UK, but in Australia and the US as well.

....I guess it's an inexact science, and it also depends on which stage you are in your menstrual cycle when you have it done.

From a laymans point of view, I can see why it seems an inexact science. I can assure you it's simply way more complicated than possible to explain easily. There is a reason why it's a shortage profession! 

I'm 99.9 percent sure you're okay. Your second smear (or even a third, if necessary) will show that you're fine. PLEASE try not to worry about it. You never know what that alone can do to your hormones. As you know, many of us on here have been falsely tried positive. It's an inexact science, at best. Will you please reply and tell us that what we've said has left you much less worried? Thanks.

saw my dr.  there were borderline changes to the cells.  mild dyskaryosis.  no evidence of kypotois (almost positive i wrote this down wrong).

she says that there's no reason to retest me immediately- she says there's no point in referring me private b/c they won't test me before (6) months is up either.  she says that even if these mild changes are cancer- they won't turn into cancer for 10 years.  my family history is irrevelent.  she says the vast majority of borderline changes reverse themselves on their own.

i will be recalled (6) months after my initial test.  if i had (3) abnormal smears in a row- i'll be referred to a colonospy. 

I had CINII back in the States.  I know how scary it is!  I had to wait 6 weeks between the results and a colpo and it felt like forever.

But I was told the same thing, that even if it were cancer, cervical cancer is slow growing.

After the colpo and biopsy, the CINII was confirmed and I had LEEP treatment on my cervix.

That was back in 2002 and I've had - touch wood! - 4 normal smear tests since then.

Also two successful pregnancies and deliveries.

I had also 1 abnormal pap smear and turned out to be nothing. I was told that most of the time the second test is normal.
By the way when I was pregnant with my first child 9 years ago, my doctor in Provo, UT told me that since I had 3 normal pap smear in a row I only needed to be tested every 3 years. But then when we moved to LA the doctor said to be tested at least every other year. I don't know who was right.
Marilena