Everything You Need To Know About An Abnormal Pap Smear

Getting a call back after a Pap smear saying the results are “abnormal” can be scary, as it tends to carry a negative connotation. But, before panic sets in, it’s important to know this is common and often not cause for major concern. In this article, we’ll explore the potential reasons for abnormal results, what to expect after an abnormal result, and the overall importance of screening. Before we dig in, let’s understand how a Pap smear works.

What is a Pap smear?

A Pap smear is an important tool in detecting abnormal cells in the cervix. This lifesaving test is designed to detect cervical cell changes in the precancerous stage, well before they progress to cervical cancer.

Often, the procedure is completed as part of your annual GYN exam along with a pelvic and breast exam. During the procedure, a small spatula or brush is used to collect cells from your cervix  and then they are sent to a lab for testing. You may experience a slight scratching feeling during the procedure, or you may feel nothing at all. We know, it’s not the most relaxing experience and it’s normal to be a bit anxious…but it shouldn’t be painful either! If you’re experiencing any major pain or discomfort during your pelvic exam, don’t hesitate to speak up and let your provider know. They may be able to use a different size speculum or make other adjustments to make the experience more comfortable for you.

The guidelines on how often you should be screened is dependent on your age and medical history. The American College of Obstetricians and Gynecologists (ACOG) recommends screening for cervical cancer begin at age 21. Cervical cancer screening may include a Pap test, testing for a virus called human papillomavirus (HPV), or both. Your provider can help you understand what screening option is best for you, but general ACOG guidelines recommend:

• If you are 21 to 29, have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
• If you are 30 to 65, you can choose one of three options: have a Pap test and an HPV test (co-testing) every 3 years, have a Pap test alone every 3 years, or have an HPV test alone every 5 years
• If you are 65 or older, you do not need screening if you’ve have no history of cervical changes and either three negative Pap test results in a row, two negative HPV tests in a row, or two negative co-test results in a row within the past 10 years. The most recent test should have been performed within the past 3 or 5 years, depending on the type of test.

As with most things, there are some exceptions to the rules. If you have HIV, a weakened immune system, or a history of cervical cancer, your provider may recommend an alternative screening plan.

Results are categorized in a few different ways. A Pap smear result can be classified as normal (or negative) meaning that no cell changes were found, unclear (or inconclusive) meaning the cervical cells look like they could be abnormal but it’s not clear, abnormal meaning some sort of change in cells was found, or unsatisfactory meaning there were not enough cells to determine a result. In each case, your provider will guide you on what’s next for screening or treatment.

Why do abnormal Pap smear results occur?

There are many reasons why a Pap smear can come back abnormal, many of which are not cause for concern. In fact, an abnormal result rarely indicates cervical cancer. Everything from recently having  sex, to having recently menstruated, if you are pregnant, or even using tampons can affect the results of your Pap smear. This is why it’s important not to jump to conclusions and panic if you do receive an abnormal result.

In some cases, an abnormal pap test may be indicative of a sexually transmitted infection (such as trichomoniasis) or a bacterial infection like bacterial vaginosis or a yeast infection. These infections may be associated with other symptoms like unusual vaginal discharge, pain, itching or burning around the vagina.

The most common cause for an abnormal pap smear is the human papillomavirus (HPV). HPV is one of the most common sexually transmitted diseases, affecting both men and women. Often, it has no obvious signs of symptoms.  In most cases, HPV will go away on its own. If it does not clear on its own, it can lead to concerns like genital warts or cervical precancer. That’s why getting a Pap smear is an excellent way to screen for any problems before they develop into cancer. There is also a vaccine for HPV that can help prevent against nine high-risk strains. It is recommended for boys and girls aged 11-12, but can be given up to age 26. Practicing safe sex with condoms can also help prevent getting HPV.

What happens next if my test results are abnormal?

If your provider finds anything suspicious, they may perform a series of tests to more closely examine the cells. This could include:

• A colposcopy, or a test to look at the vagina and cervix through a lighted magnifying tool
• An HPV test, done on a sample of cells taken from the cervix
• Another Pap test in about 6 to 12 months

If anything abnormal is discovered, they may recommend a biopsy to test a small piece of tissue for cancerous cells. Additional tests for other sexually transmitted infections may also be recommended. If another form of STI is detected, there are simple treatments available (such as antibiotics) to help clear the infection.

Bottom Line

A Pap smear and regular check-up with your Axia Women’s Health provider is a critical part of caring for your health. While it may be scary to receive an abnormal result, is not reason to panic. Remember, a Pap smear is considered a screening test, meaning it is meant to detect any changes in cells well before they progress to cancer. If you do receive an abnormal result, it’s important to follow-up with your provider.