Pap Smear Abnormal Result

Pap Smear Abnormal Result

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A normal Pap smear shows healthy squamous cells (flat cells that look like fish scales) from the surface of the cervix. There are no signs of infection and no abnormal cells. Even if your Pap results are healthy, you should be tested regularly. The tests screen for infectious agents that may be harmful if allowed to persist. Early detection of any infection will allow for better treatment and will help you maintain your health.
This diagnosis means that some of the cells on your Pap smear did not look entirely normal but did not meet diagnostic criteria for a lesion. Your doctor may either repeat your Pap smear, or perform a colposcopy . The lab may test your Pap smear specimen for HPV.
This diagnosis means there are early changes in the size and shape of the cells. LSILs are often associated with HPV, which may also cause genital warts. These lesions, in women with intact immune systems, often resolve without intervention within 18 to 24 months. Low-grade lesions may also be called mild dysplasia, or CIN1. If it is your first abnormal Pap smear, your doctor will likely recommend a colposcopy .
This diagnosis means the cells appear very different from normal cells. These precancerous lesions are more severe than with LSIL, but involve cells on the surface of the cervix. They may also be called moderate or severe dysplasia, or CIN 2 or 3. The treatment for HSIL is to remove the abnormal tissue. This can be done in several ways. See the treatment section for more information.
A precancerous condition in which there are cancerous cells in the cervix that have not yet spread away from where they started or begun to grow into the deeper tissues of the cervix. The diagnosis is usually made by a biopsy or endocervical curettage (a gentle scraping of the cervical opening). The usual treatment is a cone biopsy . In some situations, your doctor may recommend a hysterectomy (surgical removal of the uterus).
A condition in which tissues in the vulva, or external part of the vagina, begin to grow in an unusual way, causing itching or burning; the development of lesions or warts; and bleeding. If untreated, it could turn into vaginal cancer. Generally, surgical removal of the abnormal tissue is the most effective treatment. This can be done by scalpel or by laser depending on the specifics of the condition.
Women with medical conditions that affect the immune system, like HIV or lupus; or who take immune-suppressing medications; or who are organ transplant recipients, are at greater risk for cervical dysplasia.
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These images show how cervical cells that have long-lasting infections with high-risk HPV can change over time and become abnormal. Abnormal cervical cells may also return to normal even without treatment, especially in younger women. LSIL and HSIL are two types of abnormal changes to cervical squamous cells.

Updated:
March 22, 2022

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Learn about next steps after an abnormal cervical cancer screening test and follow-up care or treatment you may need to stay healthy.
Most women who receive abnormal cervical cancer screening results either have human papillomavirus ( HPV ) infections or have early cell changes that can be monitored (since they often go away on their own) or treated early (to prevent the development of cervical cancer). The information on this page can help you to learn more about abnormal cervical cancer screening results and follow-up tests and treatments.
Screening guidelines: When and how often to get screened for cervical cancer
HPV test results: What a positive or negative result means
Pap test results: What a normal, abnormal, or unsatisfactory result means
Follow-up tests and procedures after an abnormal Pap or HPV test
Treatment for high-grade cervical cell changes
Human papillomaviruses (HPVs) are a group of related viruses, some of which are spread through sexual contact. Some of these HPV types, called high-risk HPV , cause nearly all cases of cervical cancer . They can also cause anal cancer , penile cancer , vaginal cancer , vulvar cancer , and oropharyngeal cancer (cancer in the throat, usually the tonsils or the back of the tongue).
Learn more about how HPV causes cancer in HPV and Cancer.
The HPV test and the Pap test are two different cervical cancer screening tests. Screening means checking for a disease or for changes that may develop into disease before there are symptoms. Women need routine cervical cancer screenings even if they feel fine. Screening can help find changes in cervical cells so you can receive the proper follow-up care and treatment you need to stay healthy.
The HPV test checks cells for infection with high-risk HPV types.
The Pap test (also called a Pap smear or cervical cytology ) collects cervical cells and looks at them for changes caused by HPV that may—if left untreated—turn into cervical cancer. It can also detect cervical cancer cells. A Pap test also sometimes finds conditions that are not cancer, such as infection or inflammation .
The HPV/Pap cotest uses a Pap test and HPV test together to check for both high-risk HPV and cervical cell changes.
Anatomy of the female reproductive system. The organs in the female reproductive system include the cervix, uterus, ovaries, fallopian tubes, and vagina.
The cervix is the lower, narrow end of the uterus , which leads to the vagina . The cervix opens during childbirth to allow the baby to pass. It's part of the female reproductive system , as shown in the image to the right.
Both types of cervical cancer screening tests are usually done during a pelvic exam , which takes only a few minutes. During this exam, you lie on your back on an exam table, bend your knees, and put your feet into supports at the end of the table. The health care provider uses a speculum to gently open your vagina in order to see the cervix . A soft, narrow brush or tiny spatula is used to collect a small sample of cells from your cervix .
The sample of cervical cells is sent to a lab, where the cells can be checked to see if they are infected with the types of HPV that cause cancer (HPV test). The same sample can be checked for abnormal cells (Pap test/Pap smear). When both an HPV test and a Pap test are done on the same sample, this is called HPV/Pap cotesting.
A pelvic exam may include more than taking samples for an HPV and/or Pap test. Your health care provider may also check the size, shape, and position of the uterus and ovaries and feel for any lumps or cysts . The rectum may also be checked for lumps or abnormal areas. Most health care providers will tell you what to expect at each step of the exam, so you will be at ease. You may also ask to be tested for sexually transmitted infection s (STIs), also called sexually transmitted disease s (STDs).
Doctors' offices, clinics, and community health centers offer HPV and Pap tests. Many women receive these tests from their ob/gyn (obstetrics/gynecology) or primary care doctor . If you don't have a primary care provider or doctor you see regularly, you can find a clinic near you that offers cervical cancer screening by contacting:
Your health care provider may ask you:
Screening guidelines: When and how often to get screened for cervical cancer
Cervical screening recommendations have been developed by several organizations, including the United States Preventive Services Task Force (USPSTF) , the American Cancer Society (ACS) , and others.
The details of the recommendations vary, but all are based on research findings, including:
Talk with your health care provider about when to start screening, how often to be screened, and what screening test to have. These ages and times between screenings apply to most women, as long as they have normal test results.
Age 21–29 years: USPSTF recommends that women get their first Pap test at age 21 and have Pap testing every 3 years. Even if a woman is already sexually active, Pap tests are not recommended until the age of 21.
Age 30–65 years: USPSTF recommends that women in this age group be screened for cervical cancer using one of these methods:
ACS has recently published updated cervical cancer screening guidelines that recommend women start screening at age 25 with an HPV test and have HPV testing every 5 years through age 65. However, testing with an HPV/Pap cotest every 5 years or a Pap test every 3 years is still acceptable. To read about the reasons for the changes, see ACS’s Updated Cervical Cancer Screening Guidelines Explained .
Older than 65 years: Women in this age group should talk with their health care provider to learn if screening is still needed. If you have been screened regularly and had normal test results, your health care provider will probably advise you that you no longer need screening. However, if your recent test results were abnormal or you have not been screened regularly, you need to continue screening beyond age 65.
Your health care provider may recommend more frequent screening if you:
Women who’ve had an operation to remove both their uterus and cervix (called a total hysterectomy ) for reasons not related to cancer or abnormal cervical cells do not need to be screened for cervical cancer. However, if your hysterectomy was related to cervical cancer or precancer, talk with your health care provider to learn what follow-up care you need. Women who’ve had an operation to remove their uterus but not their cervix (sometimes called a partial hysterectomy or supracervical hysterectomy ) should continue routine cervical cancer screening.
HPV test results: What a positive or negative result means
HPV test results show if high-risk HPV types were found in cervical cells. An HPV test will come back as a positive test result or a negative test result :
HPV test results usually come back from the lab in about 1–3 weeks. If you don't hear from your health care provider, call and ask for your test results. Make sure you understand any follow-up visits or tests you may need.
What does it mean if a woman has a positive HPV test after years of negative tests?
Sometimes, after several negative HPV tests, a woman may have a positive HPV test result. If you have a new sexual partner, this is most likely a new infection. If you do not have a sexual partner, or if you are in a monogamous relationship, this is not necessarily a sign of a new HPV infection, and it doesn’t mean that your partner has a new sexual partner. Sometimes an HPV infection can become active again after many years. Some other viruses behave this way as well; for example, the virus that causes chickenpox can reactivate later in life to cause shingles .
There is no way to tell whether a newly positive HPV test result is a sign of a new infection or a reactivation of an old infection. Researchers don’t know whether a reactivated HPV infection has the same risk of causing cervical cell changes or cervical cancer as a new HPV infection.
Pap test results: What a normal, abnormal, or unsatisfactory result means
Pap test results show if cervical cells are normal or abnormal. A Pap test may also come back as unsatisfactory.
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Pap test results usually come back from the lab in about 1-3 weeks. If you don't hear from your health care provider, call and ask for your test results. Make sure you receive your test results and understand any follow-up visits or treatments that you need.
Follow-up tests and procedures after an abnormal Pap or HPV test
Keep in mind that most women with abnormal cervical screening test results do not have cancer. However, if you have an abnormal test result, it’s important to get the follow-up care that your health care provider recommends.
Until recently, follow-up recommendations were based on the results of a woman’s most recent screening test. However, updated ASCCP risk-based management consensus guidelines advise a more tailored approach to follow-up care.
What these updated guidelines mean is that, in addition to your current Pap, HPV, or cotest screening result, your health care provider will consider additional factors when recommending follow-up care, including:
Based on your individual risk of developing severe cervical cell changes that could become cervical cancer, you may be advised to:
These updated guidelines focus on detecting and treating severe cervical cell changes that could develop into cervical cancer while also decreasing testing and treatment for less severe conditions ( low-grade cervical cell changes).
Colposcopy and biopsy are two procedures that allow a closer look at the cells of your cervix.
During a colposcopy your health care provider inserts a speculum to gently open the vagina and view the cervix. A vi
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