By the way, doctor: What can be done about inadequate cells on a Pap test?
Q. I'm 48 years old, and 26 years ago I had a cone biopsy after an abnormal Pap test. Since then, all my Pap tests have been normal. But for the past three years, scar tissue has made it difficult for my gynecologist to get adequate cells. What do I do about Pap smears now?
A. A Pap test report of "inadequate cells" can mean either there aren't enough cells to interpret the Pap, or endocervical cells are missing. If it's insufficient cells, you can simply repeat the test in a few months. If it's lack of endocervical cells, your clinician may take extra steps to get an adequate sample.
Endocervical cells are important because they reside in the part of the endocervical canal where changes that lead to cervical cancer occur. Scarring from a cone biopsy can narrow the canal and make it difficult to obtain endocervical cells. Narrowing is also caused by falling estrogen levels and is often seen in postmenopausal women.