“I Received an Abnormal Pap Test. What's Next?” Your next step is usually a minor procedure called a colposcopy. This procedure is a visual examination of the cervix using a low-powered microscope used to find and then biopsy abnormal areas in your cervix that may lead to cervical cancer.
Most of the abnormal cells found during a Pap test are the result of a cervical or vaginal infection and are not cancerous. Abnormal Pap tests are very common. In fact, of the 3 million women with abnormal Pap tests each year, less than 1% (13,240 cases) will be diagnosed with cervical cancer.
Abnormal Pap test results: An abnormal test result may also be called a positive test result. Some of the cells of the cervix look different from the normal cells. An abnormal test result does not mean you have cancer. Your health care provider will recommend monitoring, more testing, or treatment.
If your cervical smear test shows abnormal cells, you may have a different test to look closely at your cervix. This is called a colposcopy. Sometimes the doctor or nurse doing the test can see that the cells are abnormal. They may offer you treatment to remove these cells during the colposcopy.
Some conditions that cause abnormal Pap smear results can produce uncomfortable symptoms, such as: Pain, itching or burning around the genital area during sexual intercourse or urination. Unusual vaginal discharge. Rashes, sores, warts or bumps around the genital area.
Most abnormal Pap smear results are nothing to worry about
Most women will have at least one abnormal Pap smear result in their lifetime, with an overall average of 5% of all Pap tests coming back as “abnormal.” In most cases, the abnormal result is nothing to worry about, but it's important to follow up to make sure.
Cervical cell classes: (A) normal squamous, (B) normal columnar, and (C) low-grade dysplasia; (D) high-grade dysplasia (HGD) with moderate dysplasia, (E) HGD with severe dysplasia, and (F) carcinoma in situ.
You may need treatment if the results of your colposcopy show that there are abnormal cells in your cervix. The abnormal cells will be removed, which usually involves removing an area of the cervix about the size of a finger tip.
Treatments for precancerous lesions include excision (surgical removal of the abnormal area, also referred to as a cone biopsy or conization, or loop electrosurgical excision procedure [LEEP]), cryosurgery (freezing), and laser (high-energy light). (See "Patient education: Colposcopy (Beyond the Basics)".)
If you have low grade changes but HPV is found on the sample (HPV positive), you will get an invitation for a colposcopy. This test can show whether you need treatment for the abnormal cells. You also have a colposcopy if you have high grade cell changes.
A Pap test may be done as part of a woman's routine physical examination, because it's the best way to prevent cervical cancer. But having an abnormal test result doesn't mean you have cancer. In fact, the chances that you have cancer are very small.
It's up to 30 percent of people [who] are falsely positive." Women who have a positive Pap smear generally get a colposcopy, which is an even closer examination of the cervix, vagina and vulva for signs of disease. A false positive could mean going through a biopsy during a colposcopy.
Abnormal Pap smear results are common. According to the National Institutes of Health, 3.8% of Pap tests come back abnormal. Most of the abnormal cells found during a Pap test are the result of a cervical or vaginal infection and are not cancerous.
More than 14,000 Americans develop cervical cancer each year. However, cervical cancer is a treatable condition, and there is an excellent chance of cure if the cancer is found and treated in the early stages.
If left untreated, it may take 10 years or more for precancerous conditions of the cervix to turn into cervical cancer, but in rare cases this can happen in less time. Precancerous conditions of the cervix happen in an area called the transformation zone.
Cervical cancer is generally viewed as treatable and curable, particularly if it is diagnosed when the cancer is in an early stage. This disease occurs in the cervix, or the passageway that joins the lower section of the uterus to the vagina.
Once the cancer has progressed, it can show these symptoms: Unusual vaginal bleeding, for example, after intercourse or between periods or after menopause. Watery, bloody vaginal discharge that may be heavy or have an odor. And pelvic pain or other pain can also occur during intercourse.
The abnormal tissue is removed using a thin wire loop that is heated electrically. The aim is to remove all the abnormal cells from the surface of the cervix. A LLETZ or LEEP is done under local anaesthetic in your doctor's office or under local or general anaesthetic in hospital. It takes about 10–20 minutes.
During a cone biopsy, your healthcare provider will remove a small, cone-shaped part of your cervix. They will study it under a microscope to look for abnormal cells. It usually takes about 4 to 6 weeks for your cervix to heal after this procedure.
Once abnormal cells are identified, your doctor performs a biopsy, taking a small amount of tissue for testing. You'll feel a pinch, nothing more. Then, your cells are off to the lab for analysis. You might experience some mild cramping after colposcopy, but that's it.
Results Colposcopy
If no abnormal cells were found, then you will usually be told straight away by the doctor or nurse. You will still need to attend routine cervical screening appointments in the future. If you had a biopsy you may need to wait 4 to 8 weeks to get your results.
Your healthcare provider may recommend LEEP after a Pap smear or a colposcopy biopsy confirms that you have abnormal cells in your cervix.
ASC-US is the most common abnormal Pap test result. ASC-US stands for atypical squamous cells of undetermined significance. “Squamous” refers to the type of cells that make up the tissue that covers the cervix. LSIL—This means that the cervical cells show changes that are mildly abnormal.
High-grade squamous intraepithelial lesions look somewhat to very abnormal when looked at under a microscope. They are usually caused by chronic infection with certain types of human papillomavirus (HPV) and are found when a Pap test or biopsy is done.
A colposcopy is used to find cancerous cells or abnormal cells that can become cancerous in the cervix, vagina, or vulva. These abnormal cells are sometimes called “precancerous tissue.” A colposcopy also looks for other health conditions, such as genital warts or noncancerous growths called polyps.