My Pap Smear Was Abnormal—Now What?

Health screenings can help identify diseases like cancer that can be treated more efficiently the earlier they are caught. A Pap test is that kind of screening, and it’s generally recommended that you have one every three years beginning when you’re 21. 

At A Woman’s Wellspring, Stephanie Taylor, MD, PhD, takes the time to review all of the recommended screenings with you at each women’s health appointment. If you’re due for a Pap test, she explains what you should expect during the test, when your results will be returned, and what you can expect if the result is abnormal. 

When and why to have a pap test

A pap test, or pap smear, is a screening for abnormal changes in the cervix cells that may indicate cancer. It’s often combined with a test for the human papillomavirus (HPV). 

The American College of Gynecologists (ACOG) recommends that women begin having cervical cancer screenings at the age of 21. Between the ages of 21 and 29, a pap test alone every three years or HPV testing alone between the ages of 25 and 29 is recommended. Pap tests are the preferred recommendation.

For women between 30 and 65, a pap test and an HPV test together can be done every five years, or a pap test alone can be done every three years and HPV testing every five years.

The right testing frequency depends on your health history and whether you’ve had an abnormal test in the past. 

Abnormal results

An abnormal result doesn’t mean that you have cancer, and getting an abnormal result is common. Your results can be abnormal if you have mild inflammation or minor cell changes, an infection of some kind due to a lab test error, or cancerous or precancerous cell growth.

HPV virus infections can be very mild but still cause changes in your cervical cells. Many women have mild HPV infections that clear on their own and are never even aware of it. This is one of the main reasons the ACOG guidance says women between the ages of 25 and 29 don’t necessarily need HPV tests. HPV infections are common and usually clear up quickly for people in that age group. 

Next steps

If you do have an abnormal pap test, Dr. Taylor is likely to recommend another test called a colposcopy. This test is similar to a pap smear but involves looking at the cells more closely. If necessary, Dr. Taylor then performs a biopsy or removes a very small amount of tissue for further testing.

Neither a colposcopy nor a biopsy are painful. You may have some mild cramping, but that’s the only usual side effect.

When the results of those additional diagnostic tests return, they are classified as low-, moderate-, or high-grade. Low-grade results are watch-and-wait, while moderate- or high-grade results may require removing the affected tissue. 

Get personalized guidance

You’re unique and deserve care, attention, and medical advice that considers your life, habits, history, and more. Dr. Taylor delivers that kind of personal care to all of her patients. 

Schedule an appointment today if you have questions about any regular health screenings, including a pap smear.