It’s a moment that can make your heart skip a beat—getting a call or letter saying your Pap smear result was abnormal. Immediately, your mind might jump to the worst-case scenario: “Do I have cancer?” But hold on. Before you spiral into panic, let’s break it down—because most of the time, the situation isn’t as scary as it sounds.
In this guide, we’ll walk you through what an abnormal Pap result really means, what causes it, and what happens next. Consider this your roadmap to navigating a confusing (and often misunderstood) part of women’s health.
What Does an Abnormal Pap Smear Mean?
Let’s start here. A Pap smear, or Pap test, checks for changes in the cells of your cervix—the lower part of your uterus that connects to the vagina. When your result comes back as “abnormal,” it means some of those cells don’t look quite right.
But here’s the thing: “abnormal” doesn’t automatically mean cancer. In fact, in most cases, it doesn’t even come close.
An abnormal Pap smear usually indicates one of the following:
- Mild changes (often caused by HPV)
- Inflammation or infection
- Precancerous changes that may take years (if ever) to become cancer
Think of it more like a yellow traffic light. It’s not a full-blown red alert, but your body is signaling, “Hey, let’s slow down and take a closer look.”
Types of Abnormal Pap Smear Results
Here’s where things can get a little alphabet-soupy. Your report might include terms that sound intimidating—but once you understand them, they’re actually pretty straightforward.
Let’s break down the common types:
- ASC-US (Atypical Squamous Cells of Undetermined Significance)
The most common abnormal result. It just means some cells look a bit odd, but it’s unclear why. Often linked to HPV. - LSIL (Low-grade Squamous Intraepithelial Lesion)
Mild changes, usually due to HPV. These often go away on their own, especially in younger women. - HSIL (High-grade Squamous Intraepithelial Lesion)
More serious changes that could turn into cancer if left untreated. But it still doesn’t mean cancer is present. - AGC (Atypical Glandular Cells)
Changes found in glandular cells, which are less common and may need more thorough investigation.
Confused by the jargon? You’re not alone. Just remember: the terms reflect the degree of change, not a diagnosis.
Common Causes of Abnormal Pap Smear Results
So, what causes your cervical cells to misbehave?
Here are the most common culprits:
- Human Papillomavirus (HPV)
By far the leading cause of abnormal Pap results. Some types of HPV can cause cellular changes that show up in the test. Most HPV infections resolve on their own without treatment. - Infections
Yeast infections, bacterial vaginosis, or sexually transmitted infections like chlamydia can cause temporary inflammation that alters cells. - Menstruation or recent sexual activity
If your Pap test was done while you were on your period or shortly after intercourse, it can skew the results. - Hormonal changes
Menopause or pregnancy can also influence the appearance of cervical cells.
So yes—an abnormal Pap result doesn’t always mean something serious. Sometimes it just means your body is reacting to something temporary or minor.
Is It Cancer? Probably Not — But Here’s What to Know
Let’s tackle the elephant in the room: “Do I have cancer?”
For most women, the answer is a firm no. In fact, less than 1% of women with abnormal Pap results are diagnosed with cervical cancer.
Pap smears are designed to catch changes long before they become dangerous. It’s more of a “heads up” than a diagnosis.
That said, if you’ve ignored Pap tests for many years or have persistent high-grade changes, your risk increases. But even then, treatment is usually successful when caught early.
Next Steps After an Abnormal Pap Smear
Okay, you’ve got an abnormal result—what now?
Your doctor will recommend one of several follow-up steps depending on the type and severity of the changes:
- Repeat Pap test in 6-12 months
Common for ASC-US or LSIL in younger women. Sometimes your body clears the changes naturally. - HPV testing
Helps determine if high-risk HPV is present and if further investigation is needed. - Colposcopy
A closer look at your cervix using a special microscope. It’s quick and done right in the clinic. - Biopsy
If suspicious areas are found, a small sample of tissue may be taken for lab analysis.
The goal? To monitor or remove abnormal cells before they ever become dangerous.
What is a Colposcopy and Does It Hurt?
The name sounds intimidating—but a colposcopy is usually quick and relatively painless.
During the procedure, you’ll lie on an exam table (just like a Pap test), and your provider will use a colposcope—a magnifying tool—to get a close look at your cervix. If anything looks concerning, they might do a biopsy.
The most you’ll likely feel is a bit of cramping or pinching during the biopsy. Over-the-counter pain relief like ibuprofen can help with any discomfort after.
You can go home the same day, and most people return to their usual routine immediately.
HPV and Pap Smears: How Are They Connected?
You’ve probably heard of HPV (Human Papillomavirus)—but did you know it’s incredibly common? In fact, nearly 80% of sexually active people will get it at some point.
The problem is, certain strains (like HPV-16 and HPV-18) are high-risk types that can cause cervical cell changes—and over time, cervical cancer.
That’s where Pap smears come in. They help catch those changes early, even before symptoms appear.
That’s also why many Pap smears today are co-tested with HPV screening. If both are normal, you may not need another test for five years.
Can Infections Affect Your Pap Smear?
Yes—and they’re more common than you think.
Even non-sexually transmitted infections like yeast overgrowth or bacterial vaginosis can cause inflammation that affects your Pap results.
Sometimes, the lab might even note “inflammatory changes” on your report, which just means your cervix was irritated—nothing more.
In such cases, treating the infection and repeating the test is often all that’s needed.
How Often Should You Repeat a Pap Test After an Abnormal Result?
It depends on your age and the type of abnormality.
Here’s a quick guideline (though your doctor may adjust based on your history):
- ASC-US or LSIL + no high-risk HPV: Repeat Pap in 12 months
- Positive HPV or HSIL: Immediate colposcopy or repeat test in 6 months
- After treatment (like LEEP or cryotherapy): Follow-up Pap every 6–12 months for a few years
Consistency is key here. Skipping your follow-ups is the real danger.
How to Reduce Your Risk of Abnormal Results
You can’t avoid HPV entirely—but you can lower your risk.
Here’s how:
- Get the HPV vaccine (Gardasil 9 protects against most cancer-causing strains)
- Use condoms to reduce HPV transmission
- Quit smoking, as tobacco weakens your immune system’s ability to clear infections
- Keep up with regular screenings, even if you feel fine
Simple steps. Big impact.
Emotional Reactions Are Normal — Here’s How to Cope
It’s okay to feel scared, confused, or overwhelmed. A Pap result with the word “abnormal” can trigger all sorts of emotions.
But try to remember:
- This happens to millions of women every year.
- Most cases resolve without treatment.
- You’re not alone, and there’s a clear plan for what comes next.
Talk to your doctor. Ask questions. And if anxiety is affecting your daily life, don’t hesitate to reach out to a counselor or support group.
When to Talk to a Specialist
Not every abnormal result needs a specialist, but in certain cases, your doctor might refer you to a gynaecologist or oncologist if:
- High-grade changes keep showing up
- A biopsy shows precancerous cells
- You have symptoms like unexplained bleeding or pain
It’s not a sign that something is “wrong”—just that your care needs to be more specific.
Conclusion
So, should you be worried about an abnormal Pap smear? Not necessarily.
It’s a red flag—but not a red light. With early detection, regular follow-up, and the right care, you can stay in control of your health and prevent problems long before they start.
So take a breath. You’ve got this.
References
- American Cancer Society. (2022). Understanding Your Pap Test Results. https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/pap-test-results.html
- Mayo Clinic. (2023). Abnormal Pap Smear: What it Means and What Comes Next. https://www.mayoclinic.org/tests-procedures/pap-smear/in-depth/pap-smear/art-20045167
- CDC. (2021). HPV and Cancer. https://www.cdc.gov/cancer/hpv/basic_info/index.htm
- Cleveland Clinic. (2024). Colposcopy Procedure. https://my.clevelandclinic.org/health/diagnostics/4166-colposcopy