A healthy living blog from Marshfield Clinic Health System

Abnormal Pap smear: Next steps

Thoughtful woman looking out a window - Abnormal pap smear

An abnormal Pap smear doesn’t always mean cervical cancer. You will undergo more tests and your doctor may perform a procedure to remove abnormal cells.

Pap smears are an important part of a woman’s health care because they detect abnormal cells on the outside of the cervix, including cervical cancer.

Before you panic about an abnormal Pap test, remember this: Regular Pap smears are designed to catch abnormal cells before they turn to cancer.

Dr. Ryan Arnold, a Marshfield Clinic obstetrics and gynecology physician, explained what might cause an abnormal Pap smear and the next steps after an abnormal test.

HPV causes abnormal Pap smear results

Human papillomavirus (HPV) is the most common cause of abnormal cervical cells, Arnold said.

Cells infected with HPV undergo changes that can turn into cervical cancer, but an abnormal Pap smear doesn’t always mean you have cancer. The test often catches pre-cancerous cells.

Other infections like chlamydia, bacterial vaginosis or yeast infections also may cause abnormal test results.

Abnormal results mean more tests

The type of follow-up recommended after an abnormal test depends on the severity of the abnormality.

A colposcopy is an in-office procedure used to get a close-up view of the cervix and take a tissue sample. It’s similar to a Pap smear. If the tissue sample shows a higher level of abnormal cells, you may need a loop electrosurgical excision procedure (LEEP). This is another in-office procedure to remove the abnormal cells.

Your doctor will probably recommend follow-up Pap tests to check for more abnormalities.

If any of these procedures show cervical cancer, your doctor will refer you to a gynecologic oncologist – a doctor who specializes in female reproductive cancers.

Who needs a Pap smear?

Pap smears are recommended for all women ages 21-65. Women 21-29 years old should get the test every three years if previous tests were normal. Women over 30 can continue testing every three years, but every five years with an HPV test done at the same time is preferred.

“In the past, Pap smears were done every year,” Arnold said. “The latest research shows Pap smear testing every three or five years is the best frequency to detect changes of the cervix. A pelvic exam is an important part of identifying early cervical changes and is recommended annually.”

Request an appointment for a Pap smear or pelvic exam.

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