The Final Word
In making the final diagnosis on a Pap smear test, the lab will take into account a woman's previous medical history. If she has had abnormal findings on an earlier Pap smear, she should make sure the doctor taking the sample is aware of this fact. In addition, the patient should give all details of any gynecological medical issues and any treatments undergone in the past so that this information can be included on the laboratory forms accompanying the Pap smear sample.
The person in charge of interpreting your Pap smear needs this history to help clarify his opinion of what he sees in your smear. An earlier abnormal finding also helps point the interpreter in the right direction: he will be able to look for those specific issues on your newest Pap smear for comparison.
The report is required to state something about the adequacy of the sample submitted for analysis. In the case where the sample is deemed to be inadequate, the report will explain the basis of this characterization. In the section marked "sample adequacy" the lab may report "excessive blood" or "drying artifact." These remarks signify that the lab feels the interpretation of the smear may be incorrect because the smear was somehow inadequate for testing.
In some cases, a Pap smear report will state that the sample was "unsatisfactory due to excessive inflammation." In this case, an inflammation of the woman's cervix has interfered with the lab's ability to give a proper interpretation of the smear. This is a common finding for Pap smears.
The inflammation may be due to a simple irritation or an infection. Your doctor will want to assess the cause of your inflammation and give treatment, if necessary. In any event, you will need to repeat the Pap smear once you are healed.
In the final analysis, a Pap smear diagnosis will be based on three major factors:
1) Medical History—the reader (the one responsible for interpreting the smear) factors in the medical history of the patient as noted on the lab form by the physician who took the smear.
2) Sample Adequacy—the reader makes a decision as to whether the sample was good enough for purposes of interpretation.
3) Absence or Presence of Cellular Abnormalities—the reader notes if cellular abnormalities appeared on the Pap smear slides. If the Pap smear doesn't seem to jibe with the history as reported by the submitting clinician, the reader will state this in his report.
The diagnosis will be a short phrase that gives a summary of the reader's findings, for instance: "Within normal limits."