My Pap Smear Results Were Abnormal — Now What?

A Pap smear is a quick test designed to screen for warning signs of cervical cancer, so if you just received abnormal Pap smear results, you may be wondering what’s next. 

Here’s what you need to know about abnormal Pap smear results and what to expect after one, courtesy of our team at OBGYN Westside, PLLC, located on the Upper West Side of New York City.

Learn what your results mean

Abnormal Pap smear results can vary and may indicate different types of cervical cell changes. Knowing what type of abnormal result you had is the first step in moving forward.

The main types of abnormal results include:

ASC-US (atypical squamous cells of undetermined significance)

This result indicates the presence of abnormal squamous cells on your cervix, but the changes are mild and not necessarily indicative of precancerous or cancerous cells. Certain infections, including yeast infections, can trigger an ASC-US result. 

If you receive an ASC-US result, your next steps might include a repeat Pap smear, or if you have an underlying infection, the appropriate treatment for your specific type of infection. Yeast infections, for example, may require anti-fungal creams, tablets, or suppositories. Once your infection clears, your next Pap smear should be normal.

ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion)

This result suggests that there are atypical squamous cells present on your cervix, and while they don't definitively indicate a high-grade lesion, they are more suspicious than ASC-US. 

What’s next if you receive this result? The National Cancer Institute recommends additional testing.

LSIL (low-grade squamous intraepithelial lesion)

LSIL indicates the presence of mild to moderate abnormalities in your cervical cells. You might see it referred to as mild dysplasia. While these changes are considered low-grade, they may progress to a more severe form if left untreated.

Your next step depends on if you have an HPV infection. If you have an HPV infection that doesn’t clear up and an LSIL result, the cells may need to be removed through excisional or ablative treatment.

HSIL (high-grade squamous intraepithelial lesion)

HSIL indicates the presence of more significant abnormalities in cervical cells and suggests a higher likelihood of precancerous or cancerous changes. This abnormal result is also referred to as moderate or severe dysplasia.

Prompt follow-up and treatment are typically recommended for HSIL results because these abnormal cells can sometimes turn into cancer and spread. 

AGC (atypical glandular cells)

This result indicates abnormalities in glandular cells, which are less common than squamous cells. AGC may indicate underlying issues in your cervical canal or the endometrium (lining of your uterus) and often requires further evaluation. 

Carcinoma in situ (CIS)

This result indicates the presence of cancerous cells confined to the surface of your cervix. The term “in situ” means “in its place.” In other words, while it's a precancerous stage, it hasn't spread beyond your cervix and can be treated effectively with appropriate intervention.

What happens after your abnormal result?

The type of abnormal result you receive dictates your next steps. Depending on the severity of the abnormalities and underlying factors, your provider will discuss appropriate treatment options with you. This may include monitoring your condition over time, undergoing procedures to remove abnormal cells, or receiving treatment for any underlying infections.

Additional testing after your abnormal Pap smear

Your OBGYN Westside, PLLC, provider may recommend a repeat Pap smear. This is more likely if you’ve had an unsatisfactory result. 

In addition to monitoring and a repeat Pap smear, you may benefit from follow-up testing, such as a colposcopy to further evaluate your abnormal cells. A colposcopy involves examining your cervix with a special magnifying instrument to identify any areas of concern. During this time, your provider may also perform a biopsy.

You may also need an HPV test. An HPV test checks for the presence of high-risk strains of the human papillomavirus, which can increase your risk for cervical cancer. 

Removal of precancerous cells

If your colposcopy and biopsy confirm the presence of precancerous cells, you may need a LEEP procedure. This stands for loop electrosurgical excision procedure. This treatment removes precancerous cells and has a 90% cure rate.

Additional treatments

If your results indicate cervical cancer, you may need surgery, chemotherapy, and/or radiation. Remember, though, that “abnormal” doesn’t mean you have cancer. In fact, the most common abnormal result is ACS-US, according to the National Cancer Institute.

Get the care you need

After your results are in, our team speaks with you to explain your results and answer any questions you have. If you need follow-up care, we make sure you understand each part of the process. 

If you have questions about your Pap smear or need to schedule one, give us a call or book your appointment online today.