What Does It Mean if I Have an Abnormal Pap Smear?

You’ve been to your gynecologist recently and you’ve taken your regular Pap test. A few days later, you are informed that the results of your Pap are abnormal and require follow-up. Before you panic, you should know the possible causes for your abnormal Pap smear.


What is an Abnormal Pap Smear?


First, let’s talk about what it means to have an abnormal Pap smear. When you get the results from a Pap test they fall into one of three categories: negative/normal, inconclusive and positive/abnormal. A negative or normal Pap means that only normal cells were detected in the test. An inconclusive test means that the sample of cells collected during the Pap were of poor quality and you should get tested again.

When a Pap test comes back as abnormal and requires follow-up, it means that abnormal cervical cells (called squamous cells) have been detected. It does not mean that there is anything physically abnormal about your cervix, such as a lump or tumor, just that some cells exhibit signs of abnormality.

Why is this important? Abnormal cells can be a sign that cancer could develop. However, not all abnormal cells turn cancerous.


What Could Cause an Abnormal Pap Smear?


There are a few causes for an abnormal Pap result. The most common cause is the presence of the human papillomavirus (HPV), a common sexually transmitted virus that usually does not have any symptoms. Usually, your GYN will conduct a Pap test and an HPV test at the same time. There are several strains of HPV, usually categorized by low-grade and high-grade. High-grade strains of HPV are known to cause cervical cancer, while low-grade strains are not likely to develop into cancer.

If you have been tested for HPV and the result was positive, it does not mean that you will develop cancer. Further tests will be needed to determine the likelihood of developing cancer. Getting an HPV vaccine can help to protect against multiple types of HPV, including those that cause the greatest risk of cervical cancer. The U.S. Centers for Disease and Control recommends the vaccine for women ages 26 and younger.

Other causes for an abnormal Pap smear include bacterial and yeast infections, herpes, trichomoniasis, menopausal and hormonal side effects, smoking and an impaired immune system.


What to Do if You Have an Abnormal Pap Smear


If you weren’t tested for HPV at the same time as your Pap test, your doctor will want to test you for the virus.

If your HPV test results indicate that you do have the virus, your doctor will recommend a colposcopy or biopsy to determine if the abnormal cells in your cervix are pre-cancerous. In addition to the colposcopy, your GYN will want to conduct additional Pap tests on a more frequent basis to monitor the abnormal cells.

Once again, just because your Pap test is positive or you have been diagnosed with HPV, it does not mean that you will develop cancer. In fact, most HPV cases go away on their own after two years. However, the only way to determine if your abnormal cells have cleared or have become cancerous is with frequent follow-up exams and Pap tests.

If your abnormal Pap smear does lead to a diagnosis of pre-cancerous cells, these cells can be removed before you develop cancer. In fact, when found early, cervical cancer is one of the most successfully treatable cancers.


Other Terms You May See on Your Pap Results


Cervical Dysplasia

The medical term for the condition of having abnormal cervical cells present

Carcinoma In Sita

Pre-cancerous cells

ASCUS (Atypical Squamous Cells of Undetermined Significance)
Indicates that your Pap results are borderline, meaning that they cannot be ruled to be serious or not serious

ASC-H (Atypical Squamous Cells of Undetermined Significance, Cannot Exclude HSIL)

Indicates that your Pap results could be serious

LSIL (Low-Grade Squamous Intraepithelial Lesion)

Indicates that there is a presence of mildly-abnormal cells

HSIL (High-Grade Squamous Intraepithelial Lesion)

Indicates that your Pap results are more serious


What Do I Do Now?


If your doctor is recommending additional tests, and you fear that you cannot afford further medical treatment, sign up to join The HealthyWoman Program. The HealthyWoman Program assists Pennsylvania women by providing financial support for free Pap tests and even cancer treatment to those that qualify. See if you qualify for The HealthyWoman Program today.