Got an abnormal Pap smear result? Anxious about follow-up? Confused about HPV? Breath, we break down every result type, explain what happens next, and show why most women with abnormal Paps never develop cancer. Plus, in our ‘People Also Asked’ section below, see what other women are asking or submit your own question. Let’s get started.

• About 1 in 10 Pap smears come back abnormal
• HPV causes most abnormal results
• ASCUS is the mildest result; HSIL requires treatment, but both are treatable
• Colposcopy & LEEP procedures are uncomfortable but quick with high success rates
• Regular screening catches changes early when they’re easiest to treat
• Schedule follow-up immediately and don’t skip recommended testing
• Worried about your result? Download our E-Book, view our Offers or Book a Specialist.

An abnormal Pap smear means cellular changes were detected on your cervix. That’s it. It doesn’t mean cancer.

Here’s what actually happens. During your Pap test, cells are collected from your cervix and examined under a microscope. When technicians spot changes that aren’t quite normal, that’s reported as abnormal.

How common are abnormal results? About 1 in 10 Pap smears come back abnormal. You’re not alone.

The difference? Abnormal cells exist on a spectrum. On one end, minor changes that often resolve on their own. On the other, precancerous cells needing treatment. Cancer sits at the far end. It’s rare.

Pap smears detect precancerous cells, catching problems early before they’re serious. Want to understand more about understanding your Pap smear results? Knowing the baseline helps.

Early detection saves lives. Simple as that.

Here’s what you need to know. Cervical cancer develops slowly, typically taking 10 to 15 years to progress from abnormal cells to cancer. That’s a long window. Your abnormal Pap result catches cellular changes early, when they’re easiest to monitor or treat.

But here’s what most women don’t realize. Most abnormal cells don’t progress to cancer. Ever. Your abnormal result isn’t a crisis. It’s an opportunity to watch these cells and take action if needed. That’s prevention working exactly as it should.

The HPV Connection

HPV causes most abnormal Pap smears. About 80% of sexually active people get HPV at some point. It’s not herpes or HIV. It’s transmitted through skin-to-skin contact during sex.

Here’s what helps. Most HPV infections clear on their own within 2 years. Your immune system fights it off. The problem is persistent HPV, especially high-risk strains like types 16 and 18 that cause most cervical cancers.

What happens when HPV sticks around? It interferes with normal cell development on your cervix, causing abnormal changes. HPV testing alongside Pap smears gives your provider a fuller picture. If you’ve got abnormal cells and high-risk HPV, that’s valuable information for next steps.

The HPV vaccine prevents infection with dangerous strains. Want to know more about HPV and cervical health? Understanding the connection helps you make informed decisions about prevention and follow-up care.

Other Risk Factors

Smoking damages cervical cells and makes it harder to clear HPV infections. Weakened immune systems also impair HPV clearance. We’re talking HIV, immunosuppressive medications, conditions that compromise your body’s defenses. Long-term oral contraceptive use, multiple sexual partners, and early sexual activity can increase risk.

History of other sexually transmitted infections contributes too. If you’re concerned about sexual health, getting comprehensive STD testing and prevention helps you understand related factors impacting cervical health.

ASCUS (Atypical Squamous Cells of Undetermined Significance)

ASCUS is the most common abnormal result. It’s also the mildest.

What does “undetermined significance” mean? The lab saw squamous cells that look slightly abnormal, but they can’t determine why. Could be HPV. Could be inflammation. Could be nothing serious.

Here’s what helps. About 50-60% of ASCUS results resolve on their own. Your body clears whatever caused the changes. Typical follow-up includes repeating your Pap in one year or getting an HPV test.

When’s colposcopy recommended for ASCUS? Usually if you test positive for high-risk HPV, or if repeat Paps keep showing abnormalities. Otherwise, watchful waiting works. If colposcopy is recommended, knowing what to expect during a colposcopy eases anxiety about this follow-up procedure.

ASC-H (Atypical Squamous Cells, Cannot Rule Out High-Grade Lesion)

ASC-H is more serious than ASCUS. The lab saw cellular changes that could be high-grade lesions. They’re just not certain.

What’s next? Colposcopy. Your provider needs a closer look to determine if high-grade changes are present. The progression risk is higher than ASCUS, which is why follow-up happens immediately.

LSIL (Low-Grade Squamous Intraepithelial Lesion)

LSIL, or mild dysplasia, indicates HPV-related changes. The cells show clear abnormalities, but they’re mild.

But here’s what matters. Most LSIL cases resolve without treatment, especially in younger women. Within 1 to 2 years, many women see cervical cells return to normal.

Management varies. Some providers recommend immediate colposcopy. Others prefer watchful waiting with repeat Paps every 6 to 12 months. Cancer progression risk with LSIL? Low.

HSIL (High-Grade Squamous Intraepithelial Lesion)

HSIL includes moderate to severe dysplasia. It’s still precancerous, not cancer. These abnormal cells could eventually develop into cancer if left untreated. But you’re catching them now.

HSIL requires prompt follow-up and usually treatment. Colposcopy with biopsy confirms diagnosis.

What are your treatment options? LEEP, cryotherapy, or cone biopsy. Success rates exceed 90%. Treatment effectively prevents progression to cancer. Want detailed information about the LEEP procedure? It’s the most common treatment for high-grade abnormalities.

AGC (Atypical Glandular Cells)

AGC is less common than squamous cell abnormalities. Glandular cells line the cervical canal and upper uterus.

Why does AGC require thorough investigation? These abnormalities can be trickier to pinpoint. Follow-up typically includes colposcopy with endocervical sampling and sometimes endometrial biopsy, especially if you’re over 35.

Cancer or Precancer Cells Detected

If your Pap shows squamous cell carcinoma or adenocarcinoma cells, your result indicates cancer or advanced precancer. This is serious but treatable, especially when caught early.

What happens next? Immediate colposcopy, biopsy, and likely referral to a gynecologic oncologist. Treatment depends on stage and type. Success rates are high when cervical cancer is caught early.

Prompt follow-up is essential. For comprehensive information about cervical cancer screening and prevention, understanding the full picture helps you know what questions to ask.

Understanding Your Results

Your result includes specific terminology. CIN stands for Cervical Intraepithelial Neoplasia. CIN 1 is mild dysplasia, CIN 2 is moderate, CIN 3 is severe. Higher numbers mean more abnormal cells, but these are still precancerous, not cancer.

What’s your cancer risk? CIN 1 rarely progresses to cancer. CIN 2 has about 5% chance of progressing if untreated over years. CIN 3 has about 12% chance. Treatment brings those risks way down.

Your next steps depend on result type, age, and HPV status. ASCUS might mean repeat testing in a year. HSIL likely means colposcopy and treatment.

Here’s the truth. Abnormal results are common and manageable. If your result shows HPV, telling sexual partners makes sense. It’s a health conversation, not a moral failing.

Follow-Up Testing Options

Repeat Pap smears work for mild abnormalities. Your provider might recommend another Pap in 6 or 12 months to see if changes resolve.

What about HPV testing? Testing alongside Pap smears gives more information. If you’ve got abnormal cells but no high-risk HPV, the approach may be conservative. If high-risk HPV is present, closer monitoring or immediate colposcopy makes sense.

Watch and wait is appropriate for mild abnormalities, especially in younger women. Your immune system often clears HPV within a couple years.

Colposcopy: What to Expect

Colposcopy is a closer examination using a magnifying instrument called a colposcope. The device stays outside your body. It doesn’t enter you.

The procedure feels similar to a Pap smear. You’re on an exam table with feet in stirrups. A speculum is inserted, vinegar solution is applied to your cervix to make abnormal cells visible, and the colposcope magnifies the view.

What if they spot abnormal areas? A small biopsy might be taken. You’ll feel brief cramping or pinching, similar to a strong menstrual cramp lasting a few seconds.

Pain management includes ibuprofen before the procedure. Some offices offer local anesthetic.

Afterward, expect light spotting or discharge for a few days. Avoid tampons, douching, and sex for about a week. Most women return to normal activities immediately.

Treatment Options for Abnormal Cells

When’s treatment necessary versus monitoring? Mild abnormalities like ASCUS or LSIL often don’t require treatment. High-grade abnormalities like HSIL usually do.

LEEP uses a thin wire loop heated by electrical current to remove abnormal tissue. It’s done in the office under local anesthetic, takes 10 to 20 minutes, and recovery is quick.

Cryotherapy freezes abnormal cells. Works well for smaller abnormalities.

Cone biopsy removes a cone-shaped piece of tissue, done in an operating room for serious abnormalities.

All three treatments exceed 90% success rates. Pain management includes ibuprofen and local anesthetic. Most women find over-the-counter options sufficient.

What about follow-up? Pap smears after treatment are essential, usually every 6 months initially. After consecutive normal results over 2 to 3 years, you can return to routine screening.

LEEP and cryotherapy rarely affect fertility. Cone biopsy slightly increases preterm birth risk but doesn’t prevent pregnancy.

After an abnormal Pap, you’ll need more frequent testing than the standard every-3-years schedule.

How often? After HSIL treatment, expect Pap smears every 6 months for at least 2 years. After several normal results, you might return to annual testing, then every 3 years.

Recurrence risk decreases over time with successful treatment. Continue regular screening, quit smoking if needed, and maintain a healthy immune system.

What about pregnancy? Most treatments don’t significantly impact fertility or pregnancy. LEEP and cryotherapy don’t typically affect fertility. Cone biopsy very slightly increases preterm birth risk but doesn’t prevent pregnancy.

Cervical health during pregnancy is monitored closely with a history of abnormal Paps. Pap smears during pregnancy are safe. If abnormalities are found, treatment usually waits until after delivery unless there’s cancer concern.

HPV vaccination is your strongest prevention tool, protecting against high-risk HPV types causing most cervical cancers.

Who should get the HPV vaccine? Everyone ages 9 to 26 should be vaccinated. Adults 27 to 45 can also get it. You benefit even if sexually active, as the vaccine protects against HPV types you haven’t encountered.

The difference? Vaccine effectiveness shows up to 90% reduction in HPV infections and cervical precancers.

Safer sex practices reduce HPV transmission, though condoms don’t eliminate risk. Limiting sexual partners reduces exposure, but HPV is so common that even people with few partners can contract it.

Regular Pap screening is non-negotiable. Start at age 21, continue through 65. Ages 21 to 29 get Pap every 3 years. Ages 30 to 65 get Pap every 3 years or co-testing every 5 years.

Scheduling your annual well-woman exam ensures you stay current with Pap smears and preventive care.

Schedule your follow-up appointment immediately. Don’t wait. Your provider will tell you what’s needed next, whether repeat Pap, HPV testing, or colposcopy. Get it on the calendar.

What questions should you ask? What type of abnormality was found, your HPV status, what follow-up is recommended, and the timeline for next steps.

When should you seek a second opinion? If you’re unsure about recommended treatment, your provider seems dismissive, or you want confirmation before surgery.

Advocate for yourself by asking questions until you understand, requesting written information about your results, and not accepting vague answers. You deserve clear explanations.

Track your results over time. Keep copies of all Pap smears and follow-up testing to see if things are improving, stable, or worsening.

If cost is a concern, ask about transparent pricing for all follow-up care upfront to plan accordingly.

“An abnormal Pap smear means cancer.” Wrong. Abnormal results indicate cellular changes, most precancerous at worst. Cancer is rare with regular screenings.

“Only promiscuous people get abnormal Pap smears.” Also wrong. HPV is so common that most sexually active people encounter it. You can have one partner your entire life and still get HPV. This isn’t about your choices.

“HPV means something’s wrong with me.” No. HPV is a virus, like the cold or flu. Getting it doesn’t reflect on you morally. It’s a medical fact about a very common virus.

“Abnormal results always require aggressive treatment.” Not true. Many resolve on their own. Treatment is for persistent or high-grade cases.

“Follow-up procedures will be excruciating.” Wrong. Colposcopy and LEEP are uncomfortable, not excruciating. Most women describe it as similar to period cramps.

“Treatment will make me infertile.” False. LEEP and cryotherapy don’t typically affect fertility. Cone biopsy carries very small increased risk of preterm birth but doesn’t prevent pregnancy.

Don’t worry, you’re not alone. Remember that we are here to help and support you. Your well-being is important to us, and we’re committed to assisting you through any challenges you may be facing. Besides, having questions is a good and healthy thing! Check out our additional resources below:

• Rather watch? Here’s a video of Nelly, one of our esteemed providers, discussing the topic.
• Prefer reading? Here’s an article the National Institutes of Health (NIH).
• More reading? See the American College of Obstetricians & Gynecologists (ACOG)’s Article.
• Specific medical questions? It’s best to schedule an appointment.
• General questions? Use the Live Chat on the bottom right or reach us via:
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