When your Pap smear is abnormal

Women are encouraged to start getting Pap smears at the age of 21 or within 3 years of becoming sexually active. Pap smears are used to find any abnormal cells in the cervix, thereby increasing chances for early detection and treatment of cervical cancer.

What does an abnormal pap smear mean? When your Gynecologist says that your Pap test was abnormal, it means that the test found some cells on your cervix that do not look normal. It does not mean that you have cancer. In fact, the chances that you have cancer are very small. About one in ten Pap smears usually shows some abnormality, though most are not serious. Some Pap smears indicate an unsatisfactory sample because of the sampling technique, or use of vaginal creams and douches.

Abnormal results just imply that further testing should be done to verify the cause of the abnormality. An abnormal Pap smear may indicate any of the following: an infection or inflammation, recent sexual activity, presence of Human Papilloma Virus (HPV) or dysplasia (abnormal cells that can be pre-cancerous). Further evaluation may be a repeat Pap smear, or a colposcopy (using a microscope to do a detailed evaluation of the cervix). A biopsy (removing a small amount of tissue from the cervix) may be done at the time of colposcopy.

HPV is the main risk factor for cervical cancer, but most women who receive treatment for abnormal cells caused by HPV do not develop cervical cancer. The HPV DNA test can detect high risk types of HPV before any abnormal cells can be detected on the cervix. This screening is recommended for women over the age of 30, who are at an increased risk of an HPV infection turning into pre-cancerous cells.

If the abnormal cells are persisting, you will need further treatment, which may include: cryosurgery (freezing of the abnormal cells); or excision of the abnormal area of the cervix either using a surgical blade or electrical energy (called loop excision). Minimal bleeding and watery discharge are common after this treatment. Check-ups following treatment are necessary to make sure all the abnormal cells are gone and the cervix has healed. Early detection is the key to minimize the risk of cancer developing. After treatment, women will be advised on the subsequent timing of resuming Pap smears, and with what frequency.

If a Pap smear is done during pregnancy and the results are abnormal, a colposcopy can be performed. However, further treatment may be delayed until after the baby is born. Having an abnormal Pap smear does not pose risks to the unborn baby.

Abnormal Pap smears are common, and raise anxieties in those affected. Fortunately, most of such abnormalities are innocent, and either resolve spontaneously or require simple treatments. Majority of women with abnormal Pap smears will not have cancer.