My Pap Smear Came Back Abnormal. What Now?

A Pap test, or Pap smear, is a quick and easy exam that detects cervical cancer. If you receive an “abnormal” or Pap result from your doctor, it means that there were changes in the cells found on your cervix.

Although an abnormal test result can be worrisome, it does not necessarily mean you have cancer. Of about 3 million women who receive an abnormal or unclear result from a Pap test each year, only about 10,000 are actually cases of cervical cancer.

What Does Abnormal Mean?

An abnormal result refers to changes in the cells, and there are many possible cell changes that do not indicate cervical cancer. Cells might be dying, or could be undergoing an abnormal dividing process, for example.

Possible Causes of Abnormal Cells

A few conditions might cause you to receive an abnormal result on your Pap smear, including:

HPV: Human Papillomavirus (HPV) is an incredibly common sexually transmitted infection—at least one strain of HPV will infect almost every single sexually active person on earth. This is the cause of most abnormal Pap results, and most of these cases are remedied by your body on its own. Rarer cases where cells become cancerous due to HPV tend to take 10 to 15 years to develop.
Other STIs: HPV is the most common sexually transmitted infection that causes cervical abnormalities, but it isn’t the only one. Others, including chlamydia and gonorrhea, can lead to inflamed cervical cells and trigger an abnormal result. These kinds of conditions are often treated with antibiotics, and can be avoided by practicing safe sex.
Vaginal inflammation: Any small change to the vagina’s Ph balance can lead to yeast infections or a condition called bacterial vaginosis. These conditions can lead to an abnormal Pap test and are best treated with creams and antibiotics, or with home remedies.
Pregnancy, menopause or smoking: All of these can also cause changes in the cervical cells, and may contribute to an abnormal result.

Now what?

If you receive an abnormal Pap result, your doctor will probably ask you to come back for a follow-up appointment. They’ll use a process called a colposcopy (using a special magnifying glass) to take a closer look and may take a tissue sample for testing.

If your abnormal result turns out to be HPV, STIs or vaginal inflammation, your doctor will provide treatment recommendations. If the cells are precancerous, your doctor might use one of the following methods to get rid of them:

Cryotherapy: Freezing the cells using a cold probe
Diathermy or LLETZ (large loop excision of the transformation zone): Similar procedures that employ an electric current to cut away the abnormal tissue in the cervix
Laser ablation: Using a laser to burn abnormal cells
Cone biopsy: Removing a cone-shaped part of the cervix using surgical procedures
Hysterectomy: A full removal of the uterus

Your doctor or gynecologist can provide more information about your Pap smear results.

I practice the full range of family medicine including obstetrics, pediatrics, adolescent medicine, adult medicine and some orthopedics. I also perform colposcopy, cryotherapy and vasectomies. Due to the volume of deliveries we do, my practice has evolved to be more centered on women and children’s medicine, although I enjoy all aspects of family medicine.