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My Pap smear results say “unsatisfactory sample”. What does this mean?

Sometimes the report will indicate that the sample was unsatisfactory. This may happen for a variety of reasons:

• the cells may be obscured by blood, inflammation or mucous;
• there may not be enough cells on the sample to give an accurate assessment;
• the smear may not have been properly prepared; or
• the slide may have been broken.

If any of these problems occur, you will be asked to have another Pap smear in 6-12 weeks. This allows time for the cells of the cervix to renew, so there are enough for another sample.

The diagram in Appendix 2 shows the different types of cells of the cervix.

Endocervical cells

The report from the laboratory may comment on the presence of endocervical cells in the sample. If they are present, it shows that the sample of cells comes from the area where the squamous cells meet the glandular cells. This is called the transformation zone and is where cancer is more likely to develop (see diagram in Appendix 2). It is sometimes difficult to get a sample of the cells from this area, particularly when a woman is past menopause. This is because the transformation zone tends to move up into the cervical canal at this time of life. It can also be difficult to get a sample of these cells when a woman is pregnant. The reason for this is not understood.

If endocervical cells are not seen on your Pap smear, and you have:

• had regular smears with normal results, and
• no symptoms (such as unexplained bleeding)

you do not need another Pap smear before the usual two year interval.

Atrophic changes

It is common for women who have gone through menopause to have a Pap smear result noting atrophic changes. This is caused by a reduction in the hormone oestrogen which is produced by the ovaries. This is a normal result of menopause. This lack of oestrogen can make the vaginal walls look red and irritated and is called ‘atrophic vaginitis’.

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