What Happens If I Have an Abnormal Pap Smear?

Waiting for Pap smear results isn’t much fun, but the news will be good for most women, who get the all-clear. If that happens, you needn’t give the test another thought until your next one is due, which typically won’t be for three to five years. But what if your results are abnormal?

It’s critical that you know an abnormal Pap smear result doesn’t mean you have cancer. The smear test only detects cell abnormalities, most of which won’t be cancerous. You need further tests or procedures to determine what the abnormalities are.

At Desert Hills Care Center in Las Vegas, Nevada, we always review our patients’ Pap smear results with them, but here’s an introduction to what the results show.

Understanding your Pap smear results

The majority of cervical cancers stem from human papillomavirus (HPV) infection, specifically HPV types 16 and 18. The Centers for Disease Control and Prevention (CDC) states that around  10% of women who contract cervical HPV develop long-lasting infections that put them at risk of cervical cancer.

HPV is a widespread sexually transmitted disease (STD) that many people get without realizing they’re infected. Current Pap smears typically test for the HPV virus, detecting the differences HPV causes in the cervical cells.

If your Pap smear result is positive for HPV, it doesn’t mean you have cancer but that you have an HPV infection. If your Pap smear lists ASC-US (atypical squamous cells of undetermined significance), it means your cervical cells have undergone changes, which are usually due to a previous HPV infection.

LSIL (low-grade squamous intraepithelial lesion) on a Pap smear result means the cervical cell changes are mildly abnormal. Again, an HPV infection is the likely culprit. HSIL (high-grade squamous intraepithelial lesion) denotes that the smear has discovered more significant cervical cell changes that could indicate precancer or cancer.

Other abnormal smear test results are ASC-H (atypical squamous cells, cannot exclude HSIL) and AGC (atypical glandular cells), which could also indicate precancer or cancer cell changes. Whatever the abnormal Pap smear result, you’ll need further tests to pinpoint what’s happening.

Tests required after an abnormal Pap smear

The test we recommend at Desert Hills Care Center depends on your age, what your abnormal smear result shows, your risk factors for cervical cancer, and previous Pap test results.

In some cases, you might only need a repeat smear or one that involves HPV typing to look for types 16 and 18. In other cases, you might need to undergo a minimally invasive procedure like a colposcopy, in which we examine your cervix using a magnifying instrument (colposcope).

If we see abnormal cells, we’ll take a cervical biopsy, removing a small tissue sample for lab testing.

Procedures required after an abnormal Pap smear

Depending on what the colposcopy and biopsy show, we might recommend excisional treatment (removing the affected tissue) or ablative treatment (destroying the affected tissue). The procedures we use at Desert Hills Care Center are all minimally invasive and include the following:

Loop electrosurgical excision procedure (LEEP)

LEEP involves using a thin wire loop carrying an electrical current to remove abnormal cervical tissue.

Cone biopsy

We remove a cone-shaped section of the cervix containing abnormal cells.

Cryotherapy

Cryotherapy involves freezing abnormal tissue, which then dies.

Laser therapy

Lasers use focused light beams to destroy abnormal cells.

In all these cases, we’re typically treating precancerous abnormalities — cells that could become cancerous without treatment. Sometimes, procedures like LEEP can also treat early-stage cancer, but we will always ensure that you know exactly what the abnormal result means and why we’re performing any procedure.

Call us now at Desert Hills Care Center or inquire online if you have any concerns about abnormal Pap results or the smear test in general. We’re always happy to explain anything about which you’re unsure and encourage women to undergo a Pap smear at the intervals our gynecologist recommends.