Pap Smears Abnormal Results

Pap Smears Abnormal Results

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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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The Meaning of an Abnormal Pap Smear

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Ⓒ 2022 Dotdash Media, Inc. — All rights reserved

Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.

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How Squamous Cells Can Be Affected by HPV

What Is a Pap Smear and How to Decode an Abnormal Test Result

Anal Pap Screening for Those at Higher Risk of Anal Cancer

Why Do Women Need to Get Pap Smears?

How an HSIL Pap Smear Result Is Detected

How the Cone Biopsy Is Performed to Diagnosing Cervical Conditions

What does an endocervical curettage test for?

What Does an LSIL Pap Smear Result Mean?

How Long Does It Take for Cervical Cancer to Develop?

Find out the steps involved in having a cervical biopsy

What a Cervical Intraepithelial Neoplasia Diagnosis Means

Cervical Intraepithelial Neoplasia: Signs, Symptoms, and Complications

Many Women's Clinics Provide Low-Cost or Free Pap Smears

My Journey With Stage 2B Cervical Cancer

What Are My Treatment Options for HPV?

Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Ⓒ 2022 Dotdash Media, Inc. — All rights reserved

Verywell Health is part of the Dotdash Meredith publishing family.

Brian Levine, MD, MS, FACOG, is board-certified in obstetrics and gynecology, as well as in reproductive endocrinology and infertility.

A normal Pap smear result is clear and reassuring. But an abnormal Pap smear result can seem far less definitive—and even worrisome.

Does an abnormal Pap mean cancer? Is it something to be concerned about in every case?

The answer lies in the details of your lab report. In addition to listing an abnormal result, it will provide information about the nature of the abnormal cells that were found. Each means something different about your health and what the next best steps for you may be.

Read on to learn about each of the possibilities so you can put your abnormal Pap smear results into perspective and make informed decisions about follow-up care.

ASCUS stands for atypical squamous cells of undetermined significance . In other words, there are squamous cells (cells that cover the surface of the cervix) that don't look normal. However, those cells are not abnormal enough to be considered dysplasia . 1

ASCUS is the most common abnormal Pap smear result. It is usually nothing to worry about. Although ASCUS can be caused by an early human papillomavirus (HPV) infection , an ASCUS diagnosis may also be due to irritation from sex or even bad Pap smear technique. Diagnoses of ASCUS will often resolve spontaneously over time with no intervention or treatment. 2

Follow-up for ASCUS is usually a repeat Pap smear at six months. If that's normal, then no further follow-up is necessary. At that point, a patient can return to the normal screening schedule.

Alternatively, patients diagnosed with ASCUS may be tested for HPV. Then, anyone who is positive for a high-risk type would be sent for further follow-ups, such as colposcopy or loop electrosurgical excision procedure (LEEP) .

Guidelines for follow-up for ASCUS vary with age and pregnancy status, but ASCUS does not usually require aggressive follow-up or treatment.

Squamous intraepithelial lesion (SIL) is another common abnormal Pap smear result. Squamous intraepithelial lesions are squamous cells that have been changed in a way that suggests they may eventually become cancerous.

This, however, does not mean they will become cancerous. Even without treatment, many cases of SIL will resolve on their own.

Squamous intraepithelial lesion diagnoses can be divided into two types: high grade and low grade. These correlate to cervical intraepithelial neoplasia (CIN) diagnoses of CIN 1 and CIN 2 or 3, respectively.

LSIL/CIN 1: Low grade squamous intraepithelial lesions (LSIL) are almost always a sign that a woman has been infected with HPV. This diagnosis also implies that the healthcare provider reading the Pap smear or biopsy has seen signs that look like early-stage pre-cancer.

LSIL diagnoses are relatively common. They often resolve on their own without treatment.

In very young women, follow-up is usually a repeat Pap smear in six or 12 months. For older, reproductive-age women, the American Colleges of Obstetricians and Gynecologists (ACOG) guidelines suggest colposcopy to determine the extent of the damage. They do not necessarily recommend treatment. For post-menopausal women, follow-up may be a repeat Pap smear, HPV test, or colposcopy. 2

Because LSIL does so often heal on its own, most healthcare providers advocate a less aggressive approach to follow-up rather than treatment. In fact, the ACOG guidelines state that CIN 1/LSIL should not be treated unless it has persisted for more than two years, progresses to CIN 2 or CIN 3, or other medical factors are involved.

Over-treatment, however, is still relatively common. Sometimes when people hear the phrase "pre-cancerous cells" they decide they'd rather be safe than sorry, even when the treatment can have significant side effects. 3

HSIL/CIN 2-3: High grade squamous intraepithelial lesions (HSIL) are more likely to become cervical cancer than LSIL. However, many of these lesions still regress on their own.

Carcinoma in situ (CIS) is the most serious form of HSIL and the one most likely to progress to cancer. CIS may also be diagnosed as CIN 3. 3

Guidelines state that every woman who is diagnosed with HSIL by Pap smear should be followed up by colposcopy.

During the colposcopy procedure, lesions may be biopsied, or they may be treated by LEEP, conization, freezing (cryotherapy), or laser therapy. For small enough lesions, a punch biopsy may actually be used as treatment. 4

ASC-H stands for atypical squamous cells, cannot exclude HSIL. It basically means that the healthcare providers are having trouble making a diagnosis.

You might have HSIL, you might not. The practitioners can't tell without additional testing. Follow-up by colposcopy is recommended. 2

Atypical glandular cells (AGC) refers to changes to the cervix that do not occur in the squamous epithelium. Instead, abnormal glandular cells were seen in the sample. This result suggests there may be cancer in the upper parts of the cervix or the uterus. 2

Follow-up for AGC can include colposcopy, HPV testing, and sampling of the lining of both the cervix (the endocervix) and uterus (the endometrium). The choice depends on what specific types of abnormal cells were seen in the smear.

Treatment for AGC, if necessary, is more invasive than treatment for squamous cell lesions. 2

If you have been diagnosed with cervical cancer , it means that the damage to your cervix is no longer superficial. You will probably be sent to an oncologist for further follow-up and treatment. The extent of treatment will vary by the severity of your cancer. 5

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John Hopkins Medicine. Abnormal pap test results .
The American College of Obstetricians and Gynecologists. Abnormal cervical cancer screening test results .
Khieu M, Butler SL. High grade squamous intraepithelial lesion (HSIL) [Updated 2019 Apr 2] . In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Khan MJ, Smith-mccune KK. Treatment of cervical precancers: back to basics . Obstet Gyneco l. 2014;123(6):1339-43. doi:10.1097/AOG.0000000000000287
Centers for Disease Control and Prevention. Basic information about cervical cancer .
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If the results of your Pap test come back positive, that means your doctor found abnormal or unusual cells on your cervix. It doesn't mean you have cervical cancer. Most often, the abnormal test...
What Happens After an Abnormal Pap Test? If your Pap test results are abnormal , your doctor may recommend a colposcopy. If you're told that you need a colposcopy, don't panic, says Coleman. "Women come to me saying, 'Oh, my gosh. I could have cancer!' But most women do not have cancer when they come in for a colposcopy.
Abnormal Pap test results include: ASCUS ~ Atypical squamous cells of undetermined significance 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.
Sep 27, 2021 Squamous intraepithelial lesion (SIL) is another common abnormal Pap smear result . Squamous intraepithelial lesions are squamous cells that have been changed in a way that suggests they may eventually become cancerous. This, however, does not mean they will become cancerous. Even without treatment, many cases of SIL will resolve on their own.
5. Vaginal Infection. According to the U.S. Department of Health and Human Services, an abnormal Pap test result can also indicate that you might have a vaginal infection. If you do have an ...
Abnormal Pap test results : An abnormal test result may also be called a positive test result . An abnormal test result does not mean you have cervical cancer. Possible abnormal findings on a Pap test include ASC-US, AGC, LSIL, ASC-H, HSIL, AIS, or cervical cancer.
An abnormal Pap smear may indicate that you have an infection or abnormal cells called dysplasia. It's important to remember that abnormal Pap smear results do not mean you have cancer. These results just show that further testing should be done to verify whether or not there is a problem. Women are encouraged to start getting yearly Pap ...
What " abnormal results " mean Pap smears are designed to look for the type of cell changes that are a sign of cervical cancer, but cancer isn't the only reason your results may be abnormal . If you've had Pap tests every three years, in fact, the chance of your having cancer is low, because prior tests would have shown abnormalities, too.
Abnormal or unclear results can stem from a variety of causes or factors. Some other causes of abnormal results can include: Autoimmune diseases Diabetes Hormonal changes Inflammation Noncancerous cysts Yeast infection However, the most common cause of abnormal Pap smear results is HPV, which can lead to cervical cancer if left untreated.
Sep 6, 2021 According to Rosewell Park Comprehensive Cancer Center, an estimated 5% of pap smear tests will be abnormal , and less than 1% of these tests result in cervical cancer. Common causes for an abnormal pap smear are a lab error or failure on the patients' part to adhere to pre-appointment protocols.
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