My Pap Smear Results Are Abnormal: Now What?

As board-certified women’s wellness experts who specialize in cervical cancer screening and follow-up care at Panhandle Obstetrics and Gynecology in Amarillo, Texas, our team knows it can be worrisome to learn that your Pap test results are abnormal. But “abnormal” doesn’t always mean cancer. Here’s what happens next. 

The importance of routine Pap smear testing 

Cervical cancer is the fourth most common cancer diagnosis among women worldwide. Here in the United States, about 11,500 women learn they have cervical cancer each year, and just over 4,000 women lose their lives to this “silent killer” that presents no obvious early warning signs or symptoms. 

While these statistics leave plenty of room for continued improvement, women’s preventive health care has come a long way since the early 1990s, when cervical cancer was a leading cause of cancer-related death among American women. 

Today, thanks to regular cervical cancer screenings using the Pap smear test, fewer women are dying from cervical cancer — and more women are surviving it — than ever. In fact, the cervical cancer mortality rate has declined by nearly 40% over the past three decades. 

Pap smear and HPV testing guidelines 

We conduct Pap testing during routine pelvic exams by using a slender brush to gently swab a few cells from the tissues around your cervix (the bottom part of your uterus that opens into your vagina). Pap smear testing is the only way to: 

• Find abnormal cervical cells before they become malignant 
• Detect cervical cancer in its early, most treatable stage

HPV, or human papillomavirus, is a group of more than 200 related viruses, some of which are transmitted sexually. Two types — high-risk HPV 16 and 18 — cause about 90% of cervical cancers and precancers. Given the close connection between high-risk HPV and cervical cancer, Pap smear and HPV testing guidelines are intertwined. 

Cervical cancer screening is recommended every three years for most women ages 21-65. Starting at the age of 30, you may choose one of the following options:

• A Pap test every three years
• An HPV test every five years
• A combined Pap/HPV test every five years

While HPV is common in young adult women, it often goes away on its own in time. For this reason, HPV testing is considered most beneficial for women aged 30 and older. 

What your abnormal Pap results may mean

Most abnormal Pap results don’t indicate the presence of cervical cancer — they point to the presence of cervical cell changes that can develop into cancer without treatment. These cell changes are usually the result of an HPV infection; if you have abnormal Pap results, your HPV results are probably positive too. 

Cervical cell changes fall into two categories:

Low-grade cell changes

Minor, low-grade cervical cell changes often normalize on their own. They typically require little more than watchful waiting, which usually means more frequent Pap tests. 

High-grade cell changes

Referred to as cervical precancers, high-grade cervical cell changes are more serious because they’re more likely to progress into cancer if they aren’t removed. 

Follow-up care after an abnormal Pap test

If your Pap test reveals serious, high-grade cervical cell changes, our team may recommend a follow-up diagnostic colposcopy. This simple, in-office procedure helps our team determine the nature and extent of cervical cell changes with a higher degree of accuracy. 

A closer look

A colposcopy allows us to view your cervical tissues up close and in high resolution using a special instrument called a colposcope. When a colposcopy is done to investigate abnormal Pap results, it often involves tissue sampling (biopsy) to check for the presence of cancer cells. 

Abnormal cell removal

Your colposcopy results may necessitate treatment to eliminate remaining abnormal cells before they evolve or spread. This often means having a loop electrosurgical excision procedure (LEEP). Removing cervical precancers prevents cervical cancer 95% of the time. 

Future Pap smear testing recommendations

When we find abnormal cervical cells before they’ve progressed, it’s much easier to prevent cervical cancer. As you might suspect, once you’ve had an abnormal Pap smear result, you’ll need more frequent Pap testing. 

 Women who undergo a hysterectomy to remove their cervix and cure cervical cancer still require routine Pap testing for at least 20 years following their surgery. Why? It’s still possible to develop abnormal cell changes in the same area, even long after your cervix is gone. 

To learn more about abnormal Pap results or schedule a follow-up exam at Panhandle Obstetrics and Gynecology, call 806-359-5468 today.