Abnormal Pap Smear Results: What Do They Mean and What Happens Next

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When it comes to gynecological health, a Pap smear is one of the basic tests a lot of women are familiar with as part of their yearly exam. But what happens if you get an abnormal Pap smear result? What does abnormal mean? And what happens after you get an abnormal result? Here at Kernodle OB/GYN, we are here to help you with any questions specific to your case should this concern arise, but in general, this information will help you out.

What Is A Pap Smear?

A Pap (Papanicolaou) test, or Pap smear, is a procedure used to collect cells from the cervix to be examined under a microscope to find cancerous and precancerous cells. The test is performed by your health care professional placing a speculum (an instrument to keep the vagina open) inside the vagina so the cervix can be seen clearly. Then, various samples are taken by the healthcare professional from the exocervix and endocervix. The samples are then prepared so they can be looked at under a microscope in the lab. According to the National Institutes of Health, roughly 3.8% of women will receive abnormal Pap smear results.

What Results Can You Get from A Pap Test?

According to the Centers for Disease Control and Prevention, there are three ways that a Pap test result can come back.

       1. Normal

Also referred to as “negative,” this result means that no cell changes were found on your cervix. Even with repeated normal results, you still need to get Pap tests regularly.

       2. Unclear

If the test comes back with an unclear result, your doctor may use the term “ASC-US.” These terms all mean that your cervical cells look like they could be abnormal, and it’s unclear if that’s related to HPV (human papillomavirus). HPV is the most common sexually transmitted infection and is usually harmless, but some types can lead to problems like genital warts or cancer. Unclear results could be caused by things like pregnancy, an infection, or menopause. An HPV test can clarify these results.

       3. Abnormal

This result means that cell changes were found on your cervix. An abnormal result does not mean you have cervical cancer. Usually, cell changes on the cervix are caused by HPV.

What Do Abnormal Pap Smear Results Mean?

As stated above, abnormal Pap smear results mean that the cells taken from your cervix show changes. Don’t panic, because this does not necessarily mean you have cervical cancer. Most cervical cell changes are caused by HPV.

These cell changes can be low-grade (minor) or high-grade (serious). Low-grade changes often return to normal given time. More serious changes have a higher risk of turning into cancer if they are not removed. Because they can turn into cancer but are not yet, these changed cells are called “pre-cancer.”

What Happens Next?

Again, it is important to remember that an abnormal Pap smear result does not necessarily mean you have cancer. If your Pap smear results are abnormal, your doctor will probably ask if you’ve had an abnormal Pap smear result before. 

If you get an abnormal result from your Pap test, your doctor will likely take your specific results and age into account and follow guidelines set by the American College of Obstetricians and Gynecologists (ACOG) to decide which steps to take next. You might be given an HPV test. Based on the results of your HPV test, possibilities and treatment plans may differ.


Your doctor will give you another examination and take a closer look at your cervix. This is called a colposcopy. During the colposcopy, the doctor may take a sample of cells for further testing or take a biopsy. The procedure is mildly uncomfortable but generally well tolerated by most patients.  After this procedure, the doctor may perform further testing on any collected samples and, if needed, schedule a follow-up or discuss further plans.

Depending on your specific circumstances, after further examination, your doctor may need to remove the abnormal or precancerous cells to prevent them from becoming worse or progressing into cancer.

Procedures Associated With Pap Smears

Another possibility is the doctor finding that you have cervical intraepithelial neoplasia, which is a growth that can lead to cancer on the cervical surface. In these cases, endocervical sampling is performed. If pre-cancer or early cancer is detected, it should be removed as early as possible. There are two common procedures, two different types of cone biopsies, for these purposes:

  • Loop electrosurgical procedure (LEEP or LLETZ): With this method, a thin wire loop is heated with electricity and is used like a small knife to remove the tissue. This procedure is done in your doctor’s office with the use of a local anesthetic.
  • Cold knife cone biopsy: Instead of the heated wire used in LEEP, a surgical scalpel or laser is used to remove the tissue. This procedure is done in a hospital and uses either general anesthesia or a spinal epidural.

Navigating confusing test results can be scary and daunting. At Kernodle OB/GYN, we are gynecological healthcare specialists who can help guide you through any concerns you may have about your health and well-being. If you have questions about an abnormal pap smear, or want to schedule an appointment, call (336) 538-2367.

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