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" Inflammation or Infection  Any Pap test can detect if you have a yeast infection or trichomoniasis, a common STD caused by a microscopic parasite. It can also diagnose inflammation, which can be triggered by anything that irritates your cervix -- an allergic reaction to spermicide or an IUD.  How Many Cases? About 75 percent of all women are plagued with a yeast infection at least once in their lives, and 2 million women are infected with trichomoniasis every year.  What&amp;#039;s the Next Step? You can clear up a yeast infection with a three-day OTC antifungal cream. If symptoms persist, ask your gyno for Diflucan, a prescription antiyeast pill that is stronger and more effective than the cream. For trichomoniasis, you and your partner should get a Rx for Flagyl, an antibacterial drug that has been shown to cure 95 percent of infections. (Just don&amp;#039;t drink alcohol when you take it -- the combo can cause vomiting.) Schedule a repeat exam in a month or two to confirm that the infection is really gone. If you have an inflammation but your doc can&amp;#039;t identify the particular cause, ask for a repeat Pap in three months.  ASC-US (pronounced &amp;quot;ask us&amp;quot;)  This stands for atypical squamous cells of undetermined significance, meaning abnormalities are present but it&amp;#039;s not clear why or whether they are serious. &amp;quot;An ASC-US result can be caused by inflammation or irritation from douching or sex,&amp;quot; says Louis Kuritzky, M.D., clinical assistant professor of community and family medicine at the University of Florida at Gainesville. More often, however, it could signal an HPV infection.   How Many Cases? About 2 million every year  What&amp;#039;s the Next Step? If you had a ThinPrep test, ask your doctor for a reflex HPV test, which uses the cervical cells your doctor already collected to determine if you have HPV. If you had a regular Pap, go back to your gyno for a Hybrid Capture 2 HPV DNA Test, which detects HPV on your cervix using a cervical swab. Both tests can tell whether you have a high- or low-risk type of HPV. &amp;quot;Women with a low-risk type should come back for a repeat Pap in three months to make sure it&amp;#039;s cleared up,&amp;quot; says Dr. Livoti. If you have a high-risk type, ask your doctor to do a colposcopy, an exam in which she looks at your cervix with a microscopelike instrument. If she sees abnormal cells, she&amp;#039;ll perform a biopsy by removing a small piece of tissue to determine if it&amp;#039;s precancerous or cancerous.  Mild Dysplasia  Also known as LSIL (low-grade squamous intraepithelial lesion), this is when cells on the surface of your cervix are abnormal in size or shape because of an HPV infection. It&amp;#039;s not cancer, but there is a small chance it could turn into cancer.  How Many Cases? About 1 million every year  What&amp;#039;s the Next Step? More than 80 percent of women with LSIL have a high-risk strain of HPV, so your doctor should perform a colposcopy to examine your cervical cells more closely. You should ask for a biopsy at the same time so your physician can check for cervical cancer. If you have really low-grade cell changes, schedule a repeat Pap in six months to make sure your body&amp;#039;s immune system has beaten the infection, which is what happens in most cases. If you have more serious abnormalities, your doctor can eliminate the suspicious cells with a laser or cryosurgery, which freezes the affected area. You&amp;#039;ll need to go back for Paps every three months for a year. Once your test results come back normal, you can go back to once-a-year Paps.  Moderate to Severe Dysplasia Also known as HSIL (high-grade squamous intraepithelial lesion), this means your cervical cells may be in a precancerous stage. There&amp;#039;s a chance the cells are already cancerous. HSIL is most common among women in their 20s and 30s.  How Many Cases? About 250,000 every year   What&amp;#039;s the Next Step? Get a colposcopy as soon as you can. Most clinics try to get women with high-grade changes in quickly, but if your doctor says she can&amp;#039;t fit you in for a month or two, say, &amp;quot;I&amp;#039;m feeling very anxious about this, and I&amp;#039;d like to get it done right away,&amp;quot; suggests Vivien Hanson, M.D., clinical professor in the department of epidemiology at the University of Washington School of Medicine in Seattle. Talk to your doctor about the pros and cons of doing a loop electrosurgical excision procedure, which uses an electrical current to remove the affected tissue. Dr. Livoti recommends being extra vigilant by having a Pap every three months for nine months. If those are all fine, then go down to one Pap every six months. Once those come back normal, you can resume annual testing.   Cancer Invasive cancer means the disease has spread deep into your cervix or to other tissues or organs.  How Many Cases? About 13,000 cases per year   What&amp;#039;s the Next Step? Your doctor should do a colposcopy with a biopsy to confirm the diagnosis. If you have invasive cancer, make an appointment with a gynecological oncologist at a major cancer center. &amp;quot;You want to go to a place where they see enough cases of cervical cancer to be good at treating it,&amp;quot; says Dr. Hanson. You may need a cold cone biopsy, in which a small cone-shaped sample is removed. Assuming your oncologist gets the whole affected area (she can tell because the parameter of the removed tissue will be free of lesions), you won&amp;#039;t need any further treatment except follow-up Paps. If the cancer is advanced, you may need a hysterectomy -- in which the doctor removes all or part of your uterus, fallopian tubes and ovaries -- or chemotherapy with radiation. The five-year survival rate for invasive cancer is 70 percent. "^^<http://www.w3.org/2001/XMLSchema#string>
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