What Does a LSIL Pap Smear Result Mean?

equipment for Pap smear
LGSIL is a medical term given to a level of cervical dysplasia and is detected through a Pap smear. SATURN STILLS/Science Photo Library/Getty Images

A low-grade squamous intraepithelial lesion, commonly known as LSIL or LGSIL, is detected through a routine Pap smear and means that mild cervical dysplasia has been detected.

This means that cells on the cervix are showing changes that are mildly abnormal, meaning the cells could turn into cervical cancer years down the line. The fact that they are considered "low-grade" means that the process is likely to be gradual if it happens at all.

(If the cells are diagnosed as "high-grade" or HSIL, on the other hand, it means that they could turn into cancer much faster.) 

LSIL is usually caused by the human papillomavirus (also known as HPV), which is the primary risk factor for developing cervical cancer.

HPV is very common and is transmitted by having sex (vaginal, anal, or oral) with another person who has the virus. The good news is that the majority of people infected with HPV clear the virus. But in women whose immune system does not get rid of the virus, cervical cancer can occur.

How LSIL Is Detected

When women visit their OB/GYN doctors for checkups, they often receive a Pap smear, which is sometimes called a Pap test. A Pap smear is a procedure that tests for cervical cancer in women and takes just a few minutes. This procedure involves collecting cells from the cervix which is the lower, narrow end of the uterus that's at the top of the vagina.

During a Pap smear, a woman lies on an exam table and places her feet in stirrups. The doctor then inserts a medical instrument called a speculum (which is lubricated) into the vagina and using a brush or swab, gently swipes the surface of the cervix to obtain a collection of cells. These cells are then sent to a lab to be analyzed.

Follow-up After LSIL Is Detected

If you receive a diagnosis of LSIL, it's important to follow up with your doctor, as her recommendations on how to manage the results will differ among women depending on their age, history of prior Pap smears, and results of an HPV test.

For example, if LSIL is found through a Pap smear, a repeat Pap smear in a year and/or an HPV test may be performed. An HPV test looks for the presence of certain strains of HPV associated with cervical cancer. Your doctor can usually obtain an HPV test on the same cells that were used on your initial Pap smear (the Pap smear that came back as "abnormal" because of LSIL). 

For other women who receive a diagnosis of LSIL, a colposcopy may be performed, like in women who tested positive on an HPV test or women who are between the ages of 25 and 29. 

A colposcopy is an in-office procedure that allows a doctor to examine the cervix more in-depth. When performing a colposcopy, your doctor will use a lighted microscope called a colposcope which magnifies the cervix, so it can be better visualized. 

During the colposcopy, the doctor may also do a cervical biopsy to remove small pieces of cervical tissue.  Mild cramping may occur during a cervical biopsy; however, it is relatively painless.

 The tissue samples are then sent to a lab for further examination. 

Treatment of LSIL

One of the most common ways to treat LSIL is to take a "watch and wait" approach. Since low-grade dysplasia usually resolves itself, no medical treatment may be needed, but pap smears and/or colposcopies are done at regular intervals to monitor the dysplasia.

If the dysplasia progresses, treatment may be necessary. Treatment to remove abnormal tissue may include

Loop Electrosurgical Excision Procedure (LEEP)

During a LEEP procedure, an electric current is sent through a wire loop. The wire loop acts as a knife, removing abnormal cervical cells.

Cryotherapy:

Cryotherapy is a technique that's used to destroy abnormal tissue by freezing it. It's also called cryosurgery.

Conization:

Also called a cone biopsy, conization removes a larger, cone-shaped sample of abnormal tissue.

Laser Therapy:

During laser therapy, a tiny beam of light is used to destroy abnormal cells.

A Word From Verywell

The bottom line here is that the Pap smear result of LSIL is considered "abnormal" and requires further testing and possibly treatment. But the good news is that in most cases, it clears up on its own within two years.

Even so, regular check-ups with your doctor are critical to ensuring that any abnormal cells do not persist or progress. Remember, early detection is key to lowering your chances of developing cervical cancer. 

With that, continue to see your doctor for follow-up based on her recommendations, and see her sooner if you notice new symptoms like abnormal vaginal bleeding (for example, bleeding during sex or in between periods).

Sources:

American College of Obstetricians and Gynecologists. (2016). Abnormal Cervical Cancer Screening Test Results. 

Ciavattini A et al. Follow up in women with biopsy diagnosis of cervical low-grade squamos intraepitherlial lesion (LSIL): how long should it be? Arch Gynecol Obstet. 2017 Apr;295(4):997-1003.

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