My Pap Smear Results Were Abnormal — Now What?

Cervical cancer used to be the leading cause of cancer deaths among women. That’s changed over the last 40 years, due in large part to the Pap smear. A Pap smear, also known as a Pap test, is now part of a routine well-woman exam.

A Pap smear is used to screen for precancerous cells, cells that may lead to cervical cancer. Detecting precancerous or cancerous cells early means a greater chance of a cure.

At the OB/GYN office of Dr. Hany H. Ahmed in Houston, Texas, we specialize in the management of abnormal Pap smear results, and we can help you understand what those results actually mean. In a large percentage of cases, they don’t mean you have cervical cancer.

Here’s what you need to know.

How is a Pap smear performed?

A Pap smear is performed in our office and takes just 10-20 minutes. You lie back on the table with your feet in stirrups and a sheet over your legs for privacy. 

Dr. Ahmed inserts a thin metal tool called a speculum into your vagina. The speculum allows him to widen the vaginal walls so he can see your cervix, the lower, narrow end of the uterus. He uses a swab to collect a sample of cervical cells that he sends to a laboratory for review.

A Pap smear is usually performed every three years, starting when a woman turns 21. For women over 30, the test may be combined with one for the presence of human papillomavirus (HPV) — the most common sexually transmitted disease (STD).

HPV has also been linked with cervical cancer. The HPV test is done once every five years.

What do abnormal Pap smear results mean?

The results of your test can come back negative, positive, or abnormal. Even if they’re positive or abnormal, though, that doesn’t mean you have cancer. Most commonly, the abnormal results mean there have been changes in the cervical cells caused by HPV.

However, there can be other causes. These include:

Atypical squamous cells of undetermined significance (ASCUS)

Squamous cells are thin, flat cells that grow on the surface of a healthy cervix. If ASCUS is found, it means the cells aren’t typical. To learn more, Dr. Ahmed tests the cells with a special liquid to see if HPV is present. If it’s not, you probably don’t need to worry about anything.

Squamous intraepithelial lesion

These lesions may be precancerous. Doctors categorize them as “low grade” or “high grade.”

If they’re low grade, they may not turn into cancer for many years, or they might be a sign of an HPV infection. If they’re high grade, the change can happen much sooner. In both cases, Dr. Ahmed likely orders more tests.

Atypical glandular cells

These cells grow both in the opening of the cervix and inside the uterus, and they produce mucus. If they appear to be abnormal, they could be either precancerous or cancerous, and Dr. Ahmed needs to order more tests.

Squamous cell cancer or adenocarcinoma cells

If the cells in your cervix are so abnormal that Dr. Ahmed is almost positive they’re cancerous, he likely performs two other tests and tries to treat the cancer before it spreads too far.

What’s the next step after abnormal Pap smear results?

Depending on the extent of the cells’ abnormality, Dr. Ahmed may recommend a second Pap smear or an HPV test if one wasn’t originally done. He might also order two other tests, a colposcopy, and a biopsy.

For the colposcopy, he again inserts a speculum into your vagina, but now he looks at the cervix with a colposcope, a tool with a magnifying lens and a bright light that allows him to get a more detailed look. 

He swabs the cervix with vinegar or some other solution that highlights any suspicious-looking areas and then looks through the lens of the colposcope.

If during the colposcopy, Dr. Ahmed finds areas that look to be precancerous or cancerous, he takes a biopsy, a sampling of the tissue, which he sends to a lab for further testing. The results that come back are more detailed than those from the Pap smear.

If the tests indicate abnormal cervical cells that warrant attention, Dr. Ahmed performs a cryotherapy procedure. He uses an instrument that freezes the abnormal tissue, which dies off, and the cells are shed by your body so they can’t harm you.

Is it time for you to get a Pap smear but you’re concerned about what your doctor might find? Knowledge is power, and Dr. Ahmed wants his patients to be informed — not every abnormal result is a cancer diagnosis. 

Give our office a call at 713-489-3348 to set up an appointment, or book your appointment online.