My Pap Smear Results Were Abnormal—Now What?

Cancer screenings, such as Pap smears and breast cancer screenings, are a routine part of women’s health care. These screenings help detect potential issues before they snowball into bigger ones. Pap smears – officially called a Papanicolaou smear – screen for precancerous and cancerous lesions in your cervix. Early detection of potentially cancerous lesions means you can remove those cells before they even have a chance to develop into cancer.

That’s why Dr. Molly McBride and Dr. Tamara Guichard recommend routine Pap smears here at Elite Gynecology in Midtown East, Murray Hill, New York, and Forest Hills, New York. But what happens if your results are abnormal? That’s the question our team explores today.

What does an abnormal Pap smear mean?

Before you can answer the “Now what?” question, it’s important to identify what type of cellular changes triggered an abnormal result. Although precancerous cells can cause an abnormal result, abnormal Pap smears can also be the result of the presence of inflammation or HPV infections. In other words, an abnormal test means that some of your cervical cells weren’t normal, but that doesn’t necessarily mean cancer is present.

There are many conditions — such as a vaginal infection — that can trigger an abnormal result. Engaging in intercourse within a 48-hour window of your test can also trigger an abnormal result. Because there are many reasons why you might have an abnormal result (and many of those conditions have different treatments), it’s important for us to follow up and determine the underlying cause of the abnormal result.

The next steps that Dr. McBride or Dr. Guichard recommend depends on what type of cellular changes were noted on your Pap test. According to the American College of Obstetricians and Gynecologists, abnormal results can fall into one of the following categories: 

Atypical squamous cells of undetermined significance (ASCUS)

ASCUS results mean that some of your cervical cells didn’t look quite normal, but they didn’t demonstrate enough changes to qualify as a “lesion.” If your abnormal Pap smear was listed as ASCUS, you’re not alone. This is a leading cause of abnormal Pap smear results, according to the National Cancer Institute. Yeast infections, polyps, menstruation, hormonal shifts (pregnancy or menopause), and HPV infections can cause an ASCUS result. 

Low-grade squamous intraepithelial lesion (LSIL)

If there are early and/or small changes to your cervical cells, it’s called LSIL. If your Pap test detected an LSIL, your potential next steps may include:

• An HPV test 
• A colposcopy, a test that provides a magnified view of the cervix 

Depending on the results of your colposcopy, we can also perform a biopsy at the same time.

High-grade squamous intraepithelial lesion (HSIL)

If your Pap detected an HSIL, some of your cervical cells display more severe changes, typically signaling precancerous changes. These changes are more serious than low-grade lesions. HSIL is sometimes referred to as moderate or severe dysplasia. Typically, the next steps here are to schedule a biopsy and remove any precancerous cells. If the colposcopy also confirms abnormal cells, we may recommend a LEEP procedure, an in-office treatment that treats cervical dysplasia, genital warts, and polyps. 

Atypical glandular cells (AGC)

AGC abnormal results refer to changes in your glandular cells and may indicate precancerous changes. 

Adenocarcinoma in situ 

Adenocarcinoma in situ means the Pap smear detected advanced lesions that may become cervical cancer if not treated. A colposcopy and biopsy may be needed.

Unsatisfactory results

Your Pap smear results may not be satisfactory if not enough cells were collected or if blood, semen, or mucous obstructed a clear view of your cervical cells. In this case, you’ll need to repeat your Pap test to ensure an adequate sample.

What’s next?

Although it can be overwhelming to receive an abnormal Pap test — especially if you didn’t have any concerning symptoms —  staying diligent with your follow-up recommendations ensures that you receive the care you need. 

Our team here at Elite Gynecology is experienced in treating both the underlying conditions that contributed to an abnormal result as well as performing repeat Pap smears, HPV tests, colposcopies, LEEP procedures, and biopsies. We follow all recommendations in compliance with the American College of Obstetricians and Gynecologists for abnormal Pap smears.

If you need to schedule a Pap smear or discuss your abnormal Pap smear results, request an appointment at the location closest to you.