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What if my Pap Smear Shows LSIL?

Anna T.
Anna T.

If your pap smear shows LSIL, which stands for low-grade squamous intraepithelial lesion, most doctors will not do anything immediately. You will probably be asked to come back in six months for another pap smear to see if the lesions are still present. In many cases, the lesions disappear over time and there are no further problems. If you return for your second pap smear and the finding is still present, you will probably be advised to have a coloposcopy done. A coloposcopy is a procedure performed in a doctor's office and is typically the first step in diagnosing cervical cancer.

When LSIL shows up on your pap smear results, it is a sign that you may have HPV (human papillomavirus). HPV is an infection inside the body that causes genital warts and is typically sexually transmitted. An LSIL is often the result of HPV, but it can occasionally be present for other reasons. Things that cause LSIL that are not related to HPV include cervical cell inflammation and atrophic vaginitis. Cervical cell inflammation normally goes away on its own, and atrophic vaginitis occurs almost solely in women of menopausal age who have thinning cervical tissue.

Scheduling a follow-up exam in six months is common after a pap smear shows LSIL.
Scheduling a follow-up exam in six months is common after a pap smear shows LSIL.

In addition to LSIL, some pap smears may show HSIL (high-grade squamous intraepithelial lesions). These lesions are typically taken much more seriously than LSIL, and a coloposcopy is normally performed as soon as an HSIL is discovered. HSIL are considered precancerous cells, and a person with these lesions may possibly be in the beginning stages of cervical cancer. Just as HPV typically causes low-grade squamous intraepithelial lesions, it is also normally responsible for the presence of the high-grade lesions. Even though the idea of HSIL is scary to many women, it is actually highly curable and does not always become cervical cancer if it is caught early enough.

A second pap smear will be conducted if inital test results come back positive for LSIL.
A second pap smear will be conducted if inital test results come back positive for LSIL.

The most important thing you can do if your pap smear comes back showing evidence of a low-grade squamous intraepithelial lesion is not to panic. There may be no reason to worry, and you won't know for sure until your second pap smear if anything needs addressing. When you go back for another pap smear in six months or more, the lesions may have cleared up on their own. There is also a chance that the pap smear gave false results, because errors are possible with any type of medical testing. If your pap smear showed evidence of LSIL and you were not previously aware that you might have HPV, you may want to undergo some tests for HPV to determine if that was the cause of your intraepithelial lesions.

Discussion Comments

anon269003

My girlfriend just found out she has low-grade HPV. The doctor told her it was nothing to worry about (also non cancerous). She has no side effects from this virus. She went back just to have a biopsy just to make sure everything was fine. They are still saying it is non cancerous but they want her to have a LEEP procedure done.

From all I have read, I don't feel like this needs to be done for what she has been told. If anything, shouldn't she wait another six months have another pap smear done and see what the results are from that before having a procedure like this done?

bear78

@ddljohn-- As far as I know LSIL doesn't cause problems with conception or pregnancy. My sister in law found out she had it while she was pregnant and she had a healthy pregnancy and child.

The only thing is if the LSIL is serious or if the LSIL is from HPV, it can be a problem because doctors can't do anything to treat you while you are pregnant. You have to wait until you give birth. My sister in law was in the 2nd classification so she didn't have any problems.

After delivering, she had the coloposcopy done (which now I think they do during pregnancy too) and had the vaccine for HPV which they say prevents cancer. She's doing fine now.

fify

@ddljohn-- Did your doctor tell you which class your LSIL is in?

The pap smear test results are classified into five different categories. Class I is a normal result. Class II is mild dysplasia which means that cells are abnormal but there is no growth (low risk for cancer). Dysplasia is the term used for abnormally sized and shaped cells.

Class III classification is moderate dysplasia which means that new cells are growing in an abnormal manner (moderate risk for cancer). Class IV is "carcinoma in situ" which is cancer that has not spread but remained in the location where it started. Finally Class V is invasive cancer, or cancer which has spread.

The fact that your doctor asked you to come back in 6 months for another pap smear means that you must be in either level II or level III. If you were in another level, you would have definitely been kept for more testing.

You should get the HPV testing done in the meantime to find out if that's the reason for your abnormal pap. And don't miss your second pap smear. From your description, it doesn't appear that there is much to worry about. Sometimes doctors are busy and don't go through all the details, don't be afraid to call your doctor up for a more detailed conversation.

ddljohn

I just got my pap smear results yesterday which shows LSIL and was told to come back for another smear in six months. My doctor didn't go into any details and I didn't even know that there is a risk of developing into cancer until I read this article. So naturally I'm a little worried and upset that I wasn't told about this.

All my doctor mentioned is that it might be due to a yeast infection and that they'll need to see my second pap smear to find out what's going on. They didn't even tell me to get an HPV test.

My husband and I have just started trying for a baby too. So this is like really bad timing to be going through this. I wonder, will LSIL have a negative effect on conception and pregnancy? Should I hold off trying to conceive for now?

Has anyone else had the same pap smear results recently?

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    • Scheduling a follow-up exam in six months is common after a pap smear shows LSIL.
      By: Igor Mojzes
      Scheduling a follow-up exam in six months is common after a pap smear shows LSIL.
    • A second pap smear will be conducted if inital test results come back positive for LSIL.
      By: Zsolnai Gergely
      A second pap smear will be conducted if inital test results come back positive for LSIL.
    • A colposcopy is a procedure during which a cone-shaped piece is cut from the cervix and sent for biopsy.
      By: reineg
      A colposcopy is a procedure during which a cone-shaped piece is cut from the cervix and sent for biopsy.
    • Most doctors will not do anything immediately after determining that a patient's pap smear shows LSIL.
      By: jovannig
      Most doctors will not do anything immediately after determining that a patient's pap smear shows LSIL.
    • LSIL on a pap smear result may be an indication of HPV, an infection that is transmitted sexually.
      By: ponomarencko
      LSIL on a pap smear result may be an indication of HPV, an infection that is transmitted sexually.