What Does an Abnormal Pap Smear Indicate?

A pap smear is a cell biopsy of a woman’s cervix to test for cervical cancer. If the cells are found to be abnormal, doctors may want to remove tissue to prevent cancer, which works 95% of the time.

A Pap smear (Pap test) is a test that collects cells from the cervix to check for abnormal cervical cells that can lead to cervical cancer. 

Pap tests are also used to find abnormal cervical cells before they become cancer (precancers). Removing precancers can prevent cervical cancer more than 95% of the time.

What Is a Pap Smear Used for and Who Should Get It? 

A Pap smear is used to detect cervical cancer cells early. When cervical cancer is found early, the chance of successful treatment is high. 

Experts recommend that women aged 21 to 65 get regular Pap smears as part of their routine healthcare every 3 years. 

Women older than 65 should get a Pap test if they have never been tested, or if they have not been tested after age 60. 

Even women who are not currently sexually active, have gone through menopause, or have had a hysterectomy where the cervix was left intact should receive Pap tests regularly.

A Pap smear is performed in a doctor’s office exam room and usually last about 5 minutes. 

• The patient lies on her back on the exam table and places feet in foot rests on either side of the table
• An instrument called a speculum is inserted into the vagina to allow the medical professional to see into the vagina
• A special stick or soft brush is used to collect cells from the outside of the cervix
• The patient may feel pressure when this is done
• Cells are placed on a slide or in a container and sent to a laboratory for testing
• Some light bleeding from the vagina (spotting) may occur after the procedure 

Pap smear results can be as follows: 

• Normal
  • Cells appear normal and a woman doesn’t have to do anything until her next Pap test
• Unclear
  • It is uncertain if the cells are normal or abnormal
  • Retesting may need to be done
• Abnormal
  • Cervical cells look abnormal 
  • Abnormal results do not necessarily mean cancer is present
  • In addition to cervical cancer, abnormal Pap smear results may be caused by
    • Infection 
    • Inflammation
    • Herpes
    • Trichomoniasis
    • Recent sexual activity
    • Human papilloma virus (HPV, also called genital warts)
    • Abnormal cells that may be pre-cancerous (dysplasia)
• Other tests may be performed to help make a diagnosis 
  • Another Pap test 
  • Colposcopy 
  • Biopsy

Pap smears are very safe, but complications may include: 

• The Pap test may not detect abnormal cells that are present
  • This may delay the discovery and treatment of abnormal cells of the cervix
  • Getting regular Pap tests increases the chances of finding problems
  • Since cervical cancer can take on average 10 to 20 years to develop, missed abnormal cells on one test will often be found on the next 
• The Pap test may report abnormal cells that are not there
  • This means cells are actually normal but the report comes back as abnormal
  • This may necessitate further testing