My friend and I spent a fair chunk of time this morning going over the management of abnormal pap smears. How ironic, then, to come home and turn on my computer and find this story on the BBC website about the high levels of anxiety women feel when they’re told they have an abnormal pap result—especially when (as the study rightly points out) SO very few abnormal paps are actually cancerous! Thanks to Dr. Papanicalou, cervical “cancer” is almost always caught and treated while it’s still in the pre-cancerous stage, i.e. not actually cancer at all. Yet so few women in the clinic where I’ve been working even know what the pap test is for—they generally know that they need one every year, and they dutifully come in for their annual, but they’re not always entirely sure what it’s testing. I wonder how often their pap results are carefully explained to them. I guess research like this is a good reminder to make sure that the women you’re taking care of fully understand what the results mean, so that they don’t go home terrified that they have cancer when all they have is ASCUS (atypical squamous cells of undetermined significance, which isn’t even a pre-cancerous lesion, and which will most likely spontaneously resolve on its own, since only 0.1% – 0.2% of all women with ASCUS actually have cervical cancer….i.e., one to two women out of thousand!!) I haven’t had to break the news of an abnormal pap result to a woman yet, but all of this is duly noted.