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My Pap Smear Results Were Abnormal — Now What?

The American Cancer Society estimates that nearly 14,000 women in the United States will be diagnosed with invasive cervical cancer — and about 5,000 women will die of the disease — in 2020 alone. 

While still too high, those numbers are substantially lower than they were a few decades ago, when cervical cancer was a leading cause of cancer-related death among American women. Thanks to routine cervical cancer screenings using the Pap smear test, fewer women are dying from cervical cancer — and far more women are surviving it — than ever before. 

It can be disconcerting to learn that your Pap results were abnormal, but abnormal results don’t always indicate you have cancer. Here’s what your results may mean, and what you can expect next.   

Pap test basics

Done during a routine pelvic exam, a Pap smear uses a slender brush to swab a few cells from the tissues in and around your cervix (the part of your uterus that opens into your vagina). The cells are viewed under a microscope to check for abnormal changes, or precancers, that may become cancerous if they aren’t treated properly.

Because it’s the only way to detect abnormal cervical cells before they turn cancerous, getting regular Pap tests is the best way for women of all ages to prevent invasive cervical cancer. 

Understanding HPV

HPV, or human papillomavirus, is a group of related viruses. Several different types of HPV are transmitted through sexual contact, but just two types, type 16 and type 18, are associated with cervical cancer. These so-called “high-risk” forms of HPV are known to cause abnormal cell changes that can lead to cervical cancer.

Because virtually all cases of cervical cancer are caused by HPV infections, HPV testing is usually conducted at the same time as a Pap test. Like a Pap smear, an HPV test collects cells from your cervix so they can be checked for the presence of a high-risk HPV infection.   

Abnormal Pap test results

Knowing that a Pap test is the main preventive tool against cervical cancer, it’s understandable that many women worry about the meaning of abnormal results. 

To put your mind at ease and help you prepare for next steps, however, it’s important to realize that most abnormal results do not indicate cervical cancer — they indicate the presence of cell changes that may lead to cervical cancer if left untreated. 

These abnormal cell changes are likely the result of a high-risk HPV infection; in fact, if you have abnormal Pap results, your HPV test is probably positive, too.  

Cervical cell changes are classified as minor (low-grade) or serious (high-grade), depending on their degree of abnormality. Because minor cell changes often go back to normal on their own, they usually require little more than watchful waiting, usually in the form of more frequent Pap tests.  

Serious cell changes, on the other hand, are more likely to progress into cervical cancer if they aren’t removed; that’s why these changes are often referred to as “precancer.”

Next possible steps

If your Pap results show serious cell changes, your next step will probably be a diagnostic colposcopy. This quick procedure helps determine the extent and nature of your cell changes more precisely.   

A colposcopy uses a special instrument called a colposcope that allows us to view your cervix up close and in high resolution. Depending on what we see, we may need to take a biopsy of the area. A biopsy takes a small tissue sample and checks it for the presence of cancer cells.   

Once you receive results from this procedure, you may need to undergo further treatment to get rid of abnormal cells. A loop electrosurgical excision procedure (LEEP) uses a slim wire loop with an electric current to surgically remove a thin layer of cervical tissue. 

Although LEEP can be used for diagnostic purposes, too, it’s also the best way to remove any remaining precancerous, or cancerous cells, before they have a chance to evolve or spread.  

Pap/HPV testing guidelines

Pap tests are generally recommended every three years for women between the ages of 21 and 65. Starting at the age of 30, you may continue to have a Pap test every three years, or you may opt to have a combined Pap/HPV test every five years. 

Once you’ve had an abnormal Pap result (or a cervical cancer diagnosis), you’ll need more frequent Pap tests. Even women who have a full or partial hysterectomy to remove their cervix and get rid of cervical cancer should still undergo routine Pap tests for at least 20 years following their surgery, as it’s still possible to develop abnormal cell changes in the same area.  

Remember, when abnormal cervical cells are found before they’ve had a chance to progress, it’s much easier to prevent cervical cancer. 

To learn more about abnormal Pap results or schedule a follow-up exam, call our Murray Hill, New York City, office today, or click online to schedule a visit with one of our women’s health experts any time. 

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