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Abnormal Pap smear, what does it mean?

You get your pap smear results back and it says abnormal. But what exactly does abnormal mean? Let’s take a look at all the different results and interpretations:





What is a pap smear?

A pap smear looks at the cervical cells. The pap smear test itself does not include HPV, but HPV is often added to the test for better interpretation. The goal of a pap smear is to screen for any cellular changes that can be associated with cervical cancer.

What does an abnormal pap smear mean?

An abnormal pap smear means that there were atypical cells detected on the sample. There are many different categories of test results, ranging anywhere from undetermined significance, mildly abnormal, or highly abnormal. Most abnormal pap smears are not cancerous, and often associated with vaginal infections or inflammation, but it is imperative to follow up depending on the results and what your provider suggests.

What is HPV?

Human Papillomavirus (HPV) is a virus that most sexually active females have been exposed to at one time in their life. It is often passed to us through our partner without any symptoms. Unfortunately, there is no HPV testing for males at this time. There are over 100 different types of HPV strains. In testing, it is common to test for high risk HPV strains, such as 16 & 18, and then everything else being categorized into a general “non high-risk HPV”. Because it is known that HPV is linked to cervical cancer (with type 16 and 18 being the most aggressive forms), it is often tested in addition to the pap smear results to increase detection of cervical cancer.

How do I get rid of HPV?

There is no medication to get rid of HPV, but the good news is that your body can typically clear the virus in 1-2 years, depending on the strain. Practicing safe sex can help limit exposure. The Gardasil vaccine is highly recommended from ages 9-45 to protect against the virus.

What are the next steps after an abnormal pap smear or HPV detection?

Depending on the current results, past results, and your age, your provider will give you guidance on how to proceed with further management. A common procedure after an abnormal pap smear is to follow up with a colposcopy.

What is a colposcopy?

A colposcopy is a quick procedure done in the office to have a closer look at the cervical cells. First, a speculum is inserted, just like a pap smear. Then, vinegar is applied to your cervix to help visualize any abnormal cells. An instrument is then used to help your provider get a magnified view of your cervical cells (it looks like binoculars). Any cells that look abnormal will be biopsied and sent off to pathology.

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