My Pap Smear Was Abnormal. What Next?

There’s no doubt about it, Pap smear tests save lives. These quick women’s health exams check for abnormal changes to cervical cells. When done regularly, Pap smears prevent cervical cancer. 

Receiving an abnormal Pap result can trigger immediate anxiety, but it’s important to know that most abnormal results are not cervical cancer. Infection is the most common cause of abnormal Pap results.

Here at Ideal Gynecology, board-certified gynecologist Lillian Schapiro, MD, FACOG, and the rest of our women’s health specialists, want to ease women’s fears surrounding abnormal Pap results. In the event that you receive an abnormal Pap test, our team will guide you through the next steps.  

What your results mean

You won’t be left in the dark about your abnormal Pap results. When you receive an abnormal test, our team will contact you to schedule a visit to discuss your results. 

Abnormal Pap tests encompass a range of possible changes to cervical cells, from minor changes that often resolve on their own to more significant abnormalities that might require further investigation or treatment. 

In many cases, these cell changes are caused by human papillomavirus (HPV), a common sexually transmitted infection. 

Here’s an overview of what abnormal Pap tests mean:

Atypical squamous cells of undetermined significance

This is the most common abnormal result. It means that some of the cells that line the cervix called squamous cells don't look completely normal. Undetermined significance means it's unclear whether the changes are related to HPV or other causes. Often, an HPV test is recommended following this result to determine the need for further examination or treatment.

Low-grade squamous intraepithelial lesion

This finding suggests that there are low-grade changes in the size and shape of the squamous cells, which could be related to HPV infection. These changes are usually mild, not cancerous, and may resolve on their own. 

However, our team might suggest a colposcopy to get a better look at the cervical cells. A colposcopy is a procedure that enables your Ideal Gynecology provider to get a closer look at your cervix, vagina, and vulva to check for signs of disease.

High-grade squamous intraepithelial lesion (HSIL)

When a Pap smear indicates HSIL, it means that the changes in the squamous cells are more pronounced and could progress to cancer if left untreated. These changes don't mean cancer is present, but they are more likely to lead to cervical cancer if not managed. A colposcopy and a biopsy are typically recommended to decide on the appropriate treatment.

Atypical glandular cells

These cells come from the upper part of the cervix or uterus. When a Pap test shows atypical glandular cells, further evaluation is needed to rule out more serious conditions, such as precancer or cancer, since glandular cells can be linked to more significant abnormalities than squamous cells.

Adenocarcinoma in situ

Although rare, this result indicates the presence of precancerous glandular cells that have the potential to develop into cancer. It's considered a serious condition, often leading to more extensive diagnostic procedures and treatment to ensure the abnormal cells don’t progress.

Each of these results sets a different path in motion regarding follow-up testing, monitoring, and treatment. It's important to remember that an abnormal Pap test result is a sign that further investigation is needed, but it isn’t a diagnosis of a condition. 

Top-quality women’s healthcare

If you receive an abnormal Pap test, rest assured that the Ideal Gynecology team will help you navigate the results so that you are clear on what is going on with your body and what the next steps are. If you have any questions or concerns about your Pap test, need to schedule a Pap test, or for any of your gynecological needs, give us a call to schedule a visit. Your health is our top priority.