What If My Pap Test Results are Abnormal?

If the results of your Pap test come back positive, that means your doctor found abnormal or unusual cells on your cervix. It doesn’t mean you have cervical cancer.

Most often, the abnormal test result means there have been cell changes caused by the human papilloma virus (HPV). That’s the most common sexually transmitted infection (STI), and can be linked to cervical cancer. Changes to your cervical cells caused by HPV can be mild, moderate, or severe.

Will I Need More Tests?

Your doctor will review your test results and let you know. Their answer will depend on what type of abnormal cells are found in your cervix. The most common ones are listed below.

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Atypical squamous cells of undetermined significance (ASCUS). Thin, flat cells called squamous cells grow on the surface of a healthy cervix. ASCUS occurs when these cells are not typical. Your doctor will do a test with a special liquid to see if HPV is present. If it’s not, there’s probably no need for concern.

Squamous intraepithelial lesion. These cells may be pre-cancerous. Doctors call changes to them “low-grade” or “high-grade.” If they’re low-grade, a pre- cancerous cell may not turn to cancer for many years. If it’s high-grade, the cells could turn to cancer much sooner. Your doctor will likely order more tests, including a colposcopy, an instrument that shows changes in the cervix that may lead to a biopsy of cervical tissue to check for cancerous cells.

Atypical glandular cells. These cells make mucus. They grow in the opening of your cervix and inside your uterus. If they appear to be abnormal, your doctor will order more tests, including a colposcopy, to find out for sure if it’s cancer.

Squamous cell cancer or adenocarcinoma cells. This means the cells on your cervix are so abnormal, your doctor is almost certain it’s cancer.

To be sure, your doctor will likely order two other tests -- a colposcopy and a biopsy.

During a colposcopy, your doctor will insert a speculum into your vagina, just like they did for the Pap test. This time, they’ll look at the cervix with a colposcope. This is a tool that has a lens and a bright light that allows your doctor to get a better look at your cervix. They will swab your cervix with vinegar or some other liquid solution. It’ll highlight any suspicious-looking areas. Your doctor will be able to see them through the lens on the colposcope.

If your doctor finds areas that don’t look right, they’ll take a sample, called a biopsy. They’ll send the tissue to a lab for further testing.

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