Abnormal Pap Tests: What You Need to Know

Cervical cancer is the fourth most common cancer in women. According to the National Cancer Institute, when cervical cancer is diagnosed at an early stage, the five-year survival rate is 91%. But, when cervical cancer spreads to nearby tissue, organs or lymph nodes, the five-year survival rate drops to 60%. That's why regular Pap tests are important. They can help find changes early, before cancer develops.

What is a Pap test, and how often should I get one?

A Pap test, also called a Pap smear, checks cells from your cervix for signs of changes that could lead to cancer.

Depending on your age, we’ll also test for HPV (human papillomavirus) from the same sample as your pap smear. During a pelvic exam, the provider swabs the cervix with a small, soft brush to collect cells. A Pap test is over in just a few minutes.

Screening frequency varies by age and risk factors. For most patients:

• Age 21: Get your first Pap test, repeating every three years.
• Age 30: Start co-testing—getting a Pap and HPV tests together—every five years.
• Age 65: Talk to your doctor about your health history and if you can stop getting Pap tests.

What happens if I get an abnormal Pap test?

Getting an abnormal result can feel scary, but most abnormal Pap tests do not mean you have cancer.

An abnormal Pap test result means some cells on your cervix look different than expected. A positive test result does not mean that you have cancer—it just means that you need further evaluation and testing.

The most common abnormal Pap test result is atypical squamous cells of undetermined significance (ASC-US). This means that there are cells that look abnormal, but it’s unclear what’s caused those changes. They could be caused by irritation, an infection, or normal hormonal changes—none of which are linked to cancer. Typically, the follow-up for this type of test result is an HPV test to see if the changes may be caused by the HPV virus, which causes nearly all cervical cancers.

There are several other types of abnormal Pap test results which may indicate an increased risk for cervical precancer or cancer. At MetroHealth, we’ll follow up with you after an abnormal Pap test to recommend the right course of additional testing and treatment.

What causes cervical cancer?

According to the Centers for Disease Control, HPV is thought to be responsible for more than 90% of cervical cancers.

HPV is the most common sexually transmitted infection in the United States. Nearly every sexually active adult has been exposed to HPV. Most HPV infections go away on their own within a year or two. Sometimes, though, HPV stays in the body and can lead to cancer over time. There are over 100 varieties of the HPV virus, but only a few strains of HPV cause cervical cancer.

HPV vaccination can prevent infection from the most worrisome types of HPV.

If you have children, you should talk to your provider about the HPV vaccine.

Your Questions Answered

Q. Does an abnormal Pap test mean I have cancer?

A. No. An abnormal Pap test does not mean you have cancer. It means some cells on your cervix look different than normal and may need more testing. Many abnormal results are caused by HPV (human papillomavirus) and often go away on their own.

Q. What happens after an abnormal Pap test?

A. Your healthcare provider will explain the next steps based on your results. You may need another Pap test, an HPV test or a procedure called a colposcopy, which allows your provider to take a closer look at your cervix.

Q. How can I lower my risk of cervical cancer?

A. Getting regular Pap tests and HPV screenings is one of the best ways to prevent cervical cancer. The HPV vaccine can also help protect against the types of HPV most likely to cause cervical cancer. Talk with your healthcare provider about the screening schedule that's right for you.