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If you have accessed this web site, the chances are very high that you or someone you know has had an abnormal Pap smear.

You are not alone in this experience, as it is estimated that over 3 million women in the United States alone receive this news.

We have learned, through our work as directors of cytology laboratories that diagnose Pap smears, of women's need for a clear and easily accessible source of information about their diagnosis.

Our book, Abnormal Pap Smears: What Every Woman Needs to Know, is written for women like you.


Abnormal Pap Smears: What Every Woman Needs to Know

As cytopathologists and medical directors of cytology laboratories, we have spent years training for our profession, and we now spend good portions of typical working days diagnosing abnormal Pap smears.

When speaking with women who were receiving our diagnoses, however, it became apparent that they were typically poorly informed about the specifics of their diagnoses, about the Pap smear procedure itself, a test that samples a woman's cervix for cervical cancer or its precancers, known as cervical dysplasia or 'SIL' (squamous intraepithelial lesion) . Women also were not well-informed about the proven correlation between the STD human papillomavirus (HPV), the primary cause of abnormal Pap smears, and about the connection of HPV to cervical cancer. Our motivation to write Abnormal Pap Smears: What Women Need to Know, was based on the lack of a single and easily understood source for this information.

In Abnormal Pap Smears: What Women Need to Know, we present a compendium of vital information on why women have abnormal Pap smears, what the diagnoses mean, explaining the terms 'ASCUS' (atypical cells of undetermined significance) and 'SIL'. We tell what type of treatment you can expect, and importantly, interviews with women with abnormal Pap smears who describe their experiences with the various treatments, with clear illustrations showing the pertinent female anatomy, and diagrams showing the normal-to-abnormal cell changes that characterize abnormal Pap smears.

We describe the STD HPV, a ubiquitous virus infecting many adults, that is the primary cause of cervical abnormalities such as precancers (cervical dysplasia and 'SIL) and cancer.

We also explore the latest research in the world of Pap smear technology, and discuss implications for future therapies, emphasizing that the single most important step a woman can take to prevent cervical cancer is to have regular Pap smears.

Our goal in writing Abnormal Pap Smears: What Women Need to Know is to familiarize as many women as possible about the significance of an abnormal Pap smear, and its relationship to HPV and cervical cancer. We hope this information will serve to reduce the preventable tragedy of cervical cancer in this country and throughout the world.

The need for this information is urgent. Although HPV is considered the most common STD, we were shocked to hear women with this infection speak of the guilt and shame they felt on discovering that their cervical problems were related to HPV.

The response of some women is to isolate themselves, not talking to friends or family, dealing with their problems alone and in fear of appearing promiscuous. One teenager went to great pains to shield this information from her (first) boyfriend, when clearly he was the source of her infection!

Other women did not know what to expect in the course of their workups for abnormal Pap smears, and were often distressed at the invasive, and frequently painful, nature of some of their follow-up tests, such as cervical biopsies, loop (or LEEP®) and cervical cones.

One woman became unglued when she heard the word "biopsy." She explained to us that the word was fraught with scary imagery for the average non-medical person. Another woman, who considered herself to be quite modest, was deeply upset every time she had to undergo a cervical colposcopy, normally a painless procedure.

We spoke with several brave women who were diagnosed with cervical cancer. One such woman had never had a Pap smear in her life and feared for the lives of her daughters, none of whom she could convince to have Pap smears. We joined her in her feelings of helplessness as we gazed at pictures of her six beautiful daughters.

We also spoke to some women who gave us hope, women who had close and supportive relationships with their health care providers and actively sought to both educate themselves on their cervical conditions and educate their clinicians on their needs as patients.

We want to familiarize as many women as possible about the significance of an abnormal Pap smear and its relationship to HPV and cervical cancer. We want to encourage all women to open a dialog with their clinicians, so that health professionals can help them understand their odds for developing cervical cancer, and in doing so, help women everywhere to beat the odds.

We are committed to publicizing the wide-spread nature of HPVs and their association with cervical cancer. As physicians and as mothers of young daughters, we want to help teach young women to take care of their bodies, and to educate themselves about the consequences of their behaviors, so as to reduce the preventable tragedy of cervical cancer.



Table of Contents and Chapter Questions

Chapter 1:   Cervical Cancer and Human Papillomaviruses: STDs
Chapter 2:   Pap Smears 101
Chapter 3:   How to Read Your Pap Smear Report
Chapter 4:   Follow-Up and Treatment of Abnormal Pap Smears
Chapter 5:   The Problem Pap Smear
Chapter 6:   Cervical Cancer: Dealing with the Diagnosis
Chapter 7:   Women's Stories
Chapter 8:   Obtaining an Optimal Pap Smear Result
Chapter 9:   The New Technologies: A Better Pap Smear?
Chapter 10: Lifestyle and Cervical Cancer Prevention
Chapter 11: New Directions in Cervical Cancer Prevention
Chapter 12: Your Turn: Frequently Asked Questions About Pap Smears
Chapter 13: Understanding Your Abnormal Pap Smear
Selected References