Abnormal Pap?

Featured Article, Healthy Aging, Women's Health
on January 17, 2012

For most women, a Pap smear is nothing more than a few uncomfortable seconds they have to endure in their gynecologist’s office every year. But what happens when you get that dreaded follow-up phone call that says your test came back with abnormal results?

“So many women become anxious when they get an abnormal Pap smear,” says Dr. Michael Goldan, gynecological oncologist and associate professor of medicine at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn. “And so many Paps turn out to be mild abnormalities at most.”

Don’t let the fear of an abnormal Pap smear scare you out of getting your annual Pap smear. The screening test is crucial to preventing cervical cancer, and only about 5 percent of the tests have abnormal results. “The bottom line is Pap smears work,” Gold says. 

RELATED: Tests Women Need After Age 50

Here’s what you need to know about an abnormal Pap smear result:

  • An abnormal result does not mean you have cancer. It just means that your test has detected some abnormal cells, which often disappear on their own, according to the U.S. Department of Health and Human Services. However, it is still important to follow up on an abnormal test result because with cervical cancer, early detection is key.
  • Abnormal results may be caused by HPV. If you are older than 30, your Pap smear probably included an HPV test, which was recently recommended by three leading cancer groups. HPV, or human papilloma virus, is so common that The Centers for Disease Control and Prevention reports that four out of every five women will have been infected with HPV at some point by age 50. And 90 percent of the time, your body will naturally rid itself of HPV infection within two years. However, certain high-risk strains of HPV are a very common cause of cervical cancer.
  • Your follow-up testing will be based on the type of abnormality. Dr. Patrick Duff, professor of obstetrics and gynecology at the University of Florida’s College of Medicine, notes that the lab should automatically run an HPV screen if your Pap smear detects abnormal cells to determine whether you have a high-risk strain. If you do, your clinician will probably send you for a colposcopy, a procedure in which a magnifying instrument called a colposcope is used to examine the cervix, vagina and vulva. If the doctor notices anything unusual, he can collect tissue during the colposcopy for a biopsy.
  • Cervical cancer is typically slow growing. If you’ve been diligent about getting your annual Pap smears and your last test was normal, the worst-case scenario is probably that you have “precancerous” cells. Your doctor may choose to remove them in a simple in-office procedure, or take a “wait and see” approach. That’s why Pap smears are so important: They detect abnormalities that may develop into cancer over the course of several years, but identifying them early means they can be removed before they do.
  • Abnormal Pap smear results will affect your schedule for future Pap screenings. If you have an abnormal result, you will probably have to be screened more than once a year for a while; the length of time will depend on whether you had mild dysplasia or something more serious. Check with your doctor to make sure you get the appropriate schedule of follow-up screenings.