What Do My Abnormal Pap Test Results Mean?

You had your annu­al OBG­YN appoint­ment (yes, you should have one every year!). Every­thing looked and felt nor­mal – but you’ve just learned that you had abnor­mal Pap test results. 

Pap tests are gyne­co­log­i­cal tests that screen for cer­vi­cal can­cer, and they are a rou­tine part of women’s health­care. Find­ing out that you have abnor­mal results can quick­ly send you into a tail­spin. Take a deep breath. Abnor­mal results are very com­mon and usu­al­ly don’t indi­cate can­cer. That being said, it is impor­tant to take your results seri­ous­ly – they may show that can­cer is pos­si­ble in your future. 

Here are answers to com­mon ques­tions about abnor­mal test results and what they mean for your cer­vi­cal health:

Is a Pap Test the Same as an HPV Test?

Peo­ple some­times use the terms inter­change­ably, but they are actu­al­ly two dif­fer­ent tests.

The Pap test (often called a ​“Pap smear”) looks for changes to your cer­vi­cal cells that could poten­tial­ly turn into can­cer. The HPV test looks for the human papil­lo­mavirus, which is the sex­u­al­ly trans­mit­ted virus that caus­es cer­vi­cal cells to change. The tests are often done at the same time (co-test­ing).

Anoth­er key dif­fer­ence between the two tests is how often you need them. In general,the rec­om­men­da­tions are:

Your provider may have dif­fer­ent rec­om­men­da­tions based on your per­son­al health his­to­ry and needs, so it’s impor­tant to always be open and hon­est with your provider

Read on Duly Health and Care: Prepar­ing for Your First Pap Smear

Do Abnor­mal Results Mean I Have Cancer?

Prob­a­bly not. Abnor­mal results typ­i­cal­ly don’t mean that you have can­cer. They just mean that there are changes to the cells in your cervix (the tun­nel-like organ that con­nects your uterus to your vagi­na).

When you receive abnor­mal Pap test results or a pos­i­tive HPV test, it’s like­ly that you will need a col­poscopy. This is a pro­ce­dure where your provider will check for abnor­mal tis­sue in your cervix or on the wall of your vagi­na. If they find a sus­pi­cious area, they can then per­form a biop­sy, where they take a sam­ple of abnor­mal tis­sue to test in a lab for pre­can­cer­ous or can­cer­ous cells. The pro­ce­dure usu­al­ly takes about 10 to 20 min­utes, and you can go home right after.

What Do Pap Test and Col­poscopy Results Mean?

Most abnor­mal Pap test find­ings are called ​“atyp­i­cal squa­mous cells of unde­ter­mined sig­nif­i­cance (ASC-US).” This means that it’s not clear whether or not the abnor­mal cells are caused by an HPV infec­tion. The cells might look dif­fer­ent because of cer­tain infec­tions, growths, hor­mone changes dur­ing preg­nan­cy or menopause, or irri­ta­tion. These changes aren’t relat­ed to cer­vi­cal can­cer.

If the abnor­mal cells are caused by HPV, your provider may call you back for more test­ing. In most cas­es, minor cell changes will go away on their own, with­out need­ing any treat­ment. How­ev­er, oth­er changes are more seri­ous and could mean that you have cer­vi­cal dys­pla­sia (when you have cer­vi­cal cells that are con­sid­ered ​“pre­can­cer­ous”). If they aren’t treat­ed, they could turn into cer­vi­cal can­cer down the road.

In some cas­es, your provider may have you come in for a sec­ond Pap test in a few months because of unclear results. This doesn’t nec­es­sar­i­ly mean that any­thing is wrong – your provider may just need a lit­tle more infor­ma­tion. The sam­ple might not have had enough cells, or the cells might have been hid­den by mucus or blood, mak­ing them dif­fi­cult to examine.

If I Have Pre­can­cer­ous Cells, Will I Def­i­nite­ly Devel­op Cancer?

The good news is that, if you get treat­ment, it’s unlike­ly for pre­can­cer­ous cer­vi­cal cells to turn into cancer.

This means that you don’t need to pan­ic if you learn that you have pre­can­cer­ous cells – but you do need to spring into action.

It takes about 3 to 7 years for pre­can­cer­ous cells to turn into cer­vi­cal can­cer. The treat­ments to get rid of the cells before they become can­cer­ous are high­ly effec­tive, and they work best if used ear­ly, when your cer­vi­cal dys­pla­sia isn’t as advanced.

How Are Pre­can­cer­ous Cells Treated?

Exci­sion­al treat­ments are some of the main ways to treat. These are pro­ce­dures where your provider removes abnor­mal tis­sue from the cervix. The tis­sue can be exam­ined fur­ther in a lab.

Most of the time, exci­sion­al treat­ments are out­pa­tient pro­ce­dures, mean­ing you can go home on the same day. They may require local anes­the­sia (the area where your provider is per­form­ing the pro­ce­dure is numbed) or no anes­the­sia at all. How­ev­er, there are a few treat­ments that do require gen­er­al anes­the­sia, where you’re essen­tial­ly asleep and aren’t aware of what’s hap­pen­ing dur­ing the pro­ce­dure.

It’s rec­om­mend­ed that you get test­ed for HPV six months after treat­ment. Your provider will let you know how often to con­tin­ue cer­vi­cal can­cer screen­ing based on the types of dys­pla­sia you had.

What Hap­pens If I Have an Abnor­mal Pap Test While Pregnant?

Receiv­ing abnor­mal Pap test results while you’re preg­nant may add to preg­nan­cy stress, but it’s not going to affect the heath of your baby. And being preg­nant doesn’t cause your cer­vi­cal cells to change any quick­er. It’s pos­si­ble to have a col­poscopy (where your provider checks for abnor­mal tis­sue in your cervix or on the wall of your vagi­na and removes a sam­ple to test in a lab) dur­ing preg­nan­cy, but oth­er treat­ments might have to wait until after you give birth.

Being preg­nant can have an unex­pect­ed ben­e­fit if you have abnor­mal cer­vi­cal cells — they’re often washed away nat­u­ral­ly dur­ing childbirth.

What If I Do Have Cancer?

While rare, abnor­mal Pap test results can some­times reveal cer­vi­cal can­cer. For­tu­nate­ly, cer­vi­cal can­cer is one of the most suc­cess­ful­ly treat­able can­cers, espe­cial­ly if caught in its ear­li­est stages. Almost half of all cer­vi­cal can­cers are diag­nosed before they’ve spread to oth­er parts of the body, when the sur­vival rate is very high.

Abnor­mal Pap tests and pos­i­tive HPV results are very com­mon, so there’s no rea­son to feel embar­rassed or ashamed. Stay­ing up to date on your screen­ings is an impor­tant step in pro­tect­ing your health and ensur­ing you get the care you need, if and when you need it.

Whether you need to sched­ule a Pap or HPV test, dis­cuss your results, and get treat­ment, the OBG­Y­Ns at The South Bend Clin­ic are here. Find a provider and sched­ule an appointment.